Bayesian data analysis in observational comparative effectiveness research: rationale and examples.

PubMed

Olson, William H; Crivera, Concetta; Ma, Yi-Wen; Panish, Jessica; Mao, Lian; Lynch, Scott M

2013-11-01

Many comparative effectiveness research and patient-centered outcomes research studies will need to be observational for one or both of two reasons: first, randomized trials are expensive and time-consuming; and second, only observational studies can answer some research questions. It is generally recognized that there is a need to increase the scientific validity and efficiency of observational studies. Bayesian methods for the design and analysis of observational studies are scientifically valid and offer many advantages over frequentist methods, including, importantly, the ability to conduct comparative effectiveness research/patient-centered outcomes research more efficiently. Bayesian data analysis is being introduced into outcomes studies that we are conducting. Our purpose here is to describe our view of some of the advantages of Bayesian methods for observational studies and to illustrate both realized and potential advantages by describing studies we are conducting in which various Bayesian methods have been or could be implemented.

Coronal Mass Ejections and Dimmings: A Comparative Study using MHD Simulations and SDO Observations

NASA Astrophysics Data System (ADS)

Jin, M.; Cheung, C. M. M.; DeRosa, M. L.; Nitta, N.; Schrijver, K.

2017-12-01

Solar coronal dimmings have been observed extensively in the past two decades. Due to their close association with coronal mass ejections (CMEs), there is a critical need to improve our understanding of the physical processes that cause dimmings and determine their relationship with CMEs. In this study, we investigate coronal dimmings by combining simulation and observational efforts. By utilizing a data-driven global magnetohydrodynamics model (AWSoM: Alfven-wave Solar Model), we simulate coronal dimmings resulting from different CME energetics and flux rope configurations. We synthesize the emissions of different EUV spectral bands/lines and compare with SDO/AIA and EVE observations. A detailed analysis of simulation and observation data suggests that although the transient dimming / brightening patterns could relate to plasma heating processes (either by adiabatic compression or reconnection), the long-lasting "core" and "remote" (also known as "secondary") dimmings both originate from regions with open/quasi-open fields and are caused by mass loss process. The mass loss in the remote dimming region is induced by CME-driven shock. Using metrics such as dimming depth, dimming slope, and recovery time, we investigate the relationship between dimmings and CME properties (e.g., CME mass, CME speed) in the simulation. Our result suggests that coronal dimmings encode important information about CME energetics, CME-driven shock properties, and magnetic configuration of erupting flux ropes. We also discuss how our knowledge about solar coronal dimmings could be extended to the study of stellar CMEs, which may prove important for exoplanet atmospheres and habitability but which are currently not observable.

Topical Review: Integrating Findings on Direct Observation of Family Communication in Studies Comparing Pediatric Chronic Illness and Typically Developing Samples.

PubMed

Murphy, Lexa K; Murray, Caitlin B; Compas, Bruce E

2017-01-01

To review research on observed family communication in families with children with chronic illnesses compared with families with healthy, typically developing children, and to integrate findings utilizing a unifying family communication framework. Topical review of studies that have directly observed family communication in pediatric populations and included a typically developing comparison group. Initial findings from 14 studies with diverse approaches to quantifying observed family communication suggest that families with children with chronic illnesses may demonstrate lower levels of warm and structured communication and higher levels of hostile/intrusive and withdrawn communication compared with families with healthy, typically developing children. An integrative framework of family communication may be used in future studies that examine the occurrence, correlates, and mechanisms of family communication in pediatric populations.

Physiotherapists use a small number of behaviour change techniques when promoting physical activity: A systematic review comparing experimental and observational studies.

PubMed

Kunstler, Breanne E; Cook, Jill L; Freene, Nicole; Finch, Caroline F; Kemp, Joanne L; O'Halloran, Paul D; Gaida, James E

2018-06-01

Physiotherapists promote physical activity as part of their practice. This study reviewed the behaviour change techniques physiotherapists use when promoting physical activity in experimental and observational studies. Systematic review of experimental and observational studies. Twelve databases were searched using terms related to physiotherapy and physical activity. We included experimental studies evaluating the efficacy of physiotherapist-led physical activity interventions delivered to adults in clinic-based private practice and outpatient settings to individuals with, or at risk of, non-communicable diseases. Observational studies reporting the techniques physiotherapists use when promoting physical activity were also included. The behaviour change techniques used in all studies were identified using the Behaviour Change Technique Taxonomy. The behaviour change techniques appearing in efficacious and inefficacious experimental interventions were compared using a narrative approach. Twelve studies (nine experimental and three observational) were retained from the initial search yield of 4141. Risk of bias ranged from low to high. Physiotherapists used seven behaviour change techniques in the observational studies, compared to 30 behaviour change techniques in the experimental studies. Social support (unspecified) was the most frequently identified behaviour change technique across both settings. Efficacious experimental interventions used more behaviour change techniques (n=29) and functioned in more ways (n=6) than did inefficacious experimental interventions (behaviour change techniques=10 and functions=1). Physiotherapists use a small number of behaviour change techniques. Less behaviour change techniques were identified in observational studies compared to experimental studies, suggesting physiotherapists use less BCTs clinically than experimentally. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

The GRACE Checklist: A Validated Assessment Tool for High Quality Observational Studies of Comparative Effectiveness.

PubMed

Dreyer, Nancy A; Bryant, Allison; Velentgas, Priscilla

2016-10-01

Recognizing the growing need for robust evidence about treatment effectiveness in real-world populations, the Good Research for Comparative Effectiveness (GRACE) guidelines have been developed for noninterventional studies of comparative effectiveness to determine which studies are sufficiently rigorous to be reliable enough for use in health technology assessments. To evaluate which aspects of the GRACE Checklist contribute most strongly to recognition of quality. We assembled 28 observational comparative effectiveness articles published from 2001 to 2010 that compared treatment effectiveness and/or safety of drugs, medical devices, and medical procedures. Twenty-two volunteers from academia, pharmaceutical companies, and government agencies applied the GRACE Checklist to those articles, providing 56 assessments. Ten senior academic and industry experts provided assessments of overall article quality for the purpose of decision support. We also rated each article based on the number of annual citations and impact factor of the journal in which the article was published. To identify checklist items that were most predictive of quality, classification and regression tree (CART) analysis, a binary, recursive, partitioning methodology, was used to create 3 decision trees, which compared the 56 article assessments with 3 external quality outcomes: (1) expert assessment of overall quality, (2) citation frequency, and (3) impact factor. A fourth tree looked at the composite outcome of all 3 quality indicators. The best predictors of quality included the following: use of concurrent comparators, limiting the study to new initiators of the study drug, equivalent measurement of outcomes in study groups, collecting data on most if not all known confounders or effect modifiers, accounting for immortal time bias in the analysis, and use of sensitivity analyses to test how much effect estimates depended on various assumptions. Only sensitivity analyses appeared consistently as

A comparative study of kalman filtering based observer and sliding mode observer for state of charge estimation

NASA Astrophysics Data System (ADS)

Ben Sassi, Hicham; Errahimi, Fatima; Es-Sbai, Najia; Alaoui, Chakib

2018-05-01

Nowadays, electric mobility is starting to define society and is becoming more and more irreplaceable and essential to daily activities. Safe and durable battery is of a great significance for this type of mobility, hence the increasing interest of research activity oriented to battery studies, in order to assure safe operating mode and to control the battery in case of any abnormal functioning conditions that could damage the battery if not properly managed. Lithium-ion technology is considered the most suitable existing technology for electrical storage, because of their interesting features such as their relatively long cycle life, lighter weight, their high energy density, However, there is a lot of work that is still needed to be done in order to assure safe operating lithium-ion batteries, starting with their internal status monitoring, cell balancing within a battery pack, and thermal management. Tasks that are accomplished by the battery management system (BMS) which uses the state of charge (SOC) as an indicator of the internal charge level of the battery, in order to avoid unpredicted system interruption. Since the state of charge is an inner state of a the battery which cannot be directly measured, a powerful estimation technique is inevitable, in this paper we investigate the performances of tow estimation strategies; kalman filtering based observers and sliding mode observers, both strategies are compared in terms of accuracy, design requirement, and overall performances.

Comparing models of star formation simulating observed interacting galaxies

NASA Astrophysics Data System (ADS)

Quiroga, L. F.; Muñoz-Cuartas, J. C.; Rodrigues, I.

2017-07-01

In this work, we make a comparison between different models of star formation to reproduce observed interacting galaxies. We use observational data to model the evolution of a pair of galaxies undergoing a minor merger. Minor mergers represent situations weakly deviated from the equilibrium configuration but significant changes in star fomation (SF) efficiency can take place, then, minor mergers provide an unique scene to study SF in galaxies in a realistic but yet simple way. Reproducing observed systems also give us the opportunity to compare the results of the simulations with observations, which at the end can be used as probes to characterize the models of SF implemented in the comparison. In this work we compare two different star formation recipes implemented in Gadget3 and GIZMO codes. Both codes share the same numerical background, and differences arise mainly in the star formation recipe they use. We use observations from Pico dos Días and GEMINI telescopes and show how we use observational data of the interacting pair in AM2229-735 to characterize the interacting pair. Later we use this information to simulate the evolution of the system to finally reproduce the observations: Mass distribution, morphology and main features of the merger-induced star formation burst. We show that both methods manage to reproduce roughly the star formation activity. We show, through a careful study, that resolution plays a major role in the reproducibility of the system. In that sense, star formation recipe implemented in GIZMO code has shown a more robust performance. Acknowledgements: This work is supported by Colciencias, Doctorado Nacional - 617 program.

Strengthening the reliability and credibility of observational epidemiology studies by creating an Observational Studies Register.

PubMed

Swaen, Gerard M H; Carmichael, Neil; Doe, John

2011-05-01

To evaluate the need for the creation of a system in which observational epidemiology studies are registered; an Observational Studies Register (OSR). The current scientific process for observational epidemiology studies is described. Next, a parallel is made with the clinical trials area, where the creation of clinical trial registers has greatly restored and improved their credibility and reliability. Next, the advantages and disadvantages of an OSR are compared. The advantages of an OSR outweigh its disadvantages. The creation of an OSR, similar to the existing Clinical Trials Registers, will improve the assessment of publication bias and will provide an opportunity to compare the original study protocol with the results reported in the publication. Reliability, credibility, and transparency of observational epidemiology studies are strengthened by the creation of an OSR. We propose a structured, collaborative, and coordinated approach for observational epidemiology studies that can provide solutions for existing weaknesses and will strengthen credibility and reliability, similar to the approach currently used in clinical trials, where Clinical Trials Registers have played a key role in strengthening their scientific value. Copyright © 2011 Elsevier Inc. All rights reserved.

Prospective observational study comparing three different treatment regimes in patients with Clostridium difficile infection.

PubMed

Wenisch, Judith M; Schmid, Daniela; Kuo, Hung-Wei; Allerberger, Franz; Michl, Verena; Tesik, Philip; Tucek, Gerhard; Laferl, Hermann; Wenisch, Christoph

2012-04-01

In a hospital-based, prospective cohort study, the effects of the three standard treatment regimens for mild Clostridium difficile infection (CDI), oral (p.o.) metronidazole at 500 mg three times/day, intravenous (i.v.) metronidazole at 500 mg three times/day, and oral (p.o.) vancomycin at 250 mg four times/day, were compared with respect to the risk of occurrence of complications, sequelae, and all-cause death within 30 days after the date of starting treatment. Differences in the incidence of these outcomes were tested by χ² or Fisher's exact tests. A Poisson regression model was performed to control for possible confounding effects of sex, age, and severity of comorbidity categorized according to the Charlson comorbidity index. The highest mortality was observed in the metronidazole i.v. group, with a mortality rate 38.1% (16/42) compared to mortality rates of 7.4% (9/121) in the metronidazole p.o. group and 9.5% (4/42) in the vancomycin p.o. group (P < 0.001). After adjustment for possible effects of sex, age (> 65 years), and severity of comorbidity, the relative risk of a 30-day fatal outcome for patients receiving metronidazole i.v. was 4.3 (95% confidence interval [CI] = 1.92 to 10; P < 0.0001) compared to patients treated with metronidazole p.o. and 4.0 (95% CI = 1.31 to 5.0; P < 0.015) compared to patients treated with vancomycin p.o. There were no significant differences in the risk of complications between the three treatment groups. This study generates the hypothesis that treatment with i.v. metronidazole is inferior to the oral alternatives metronidazole and vancomycin.

Prospective Observational Study Comparing Three Different Treatment Regimes in Patients with Clostridium difficile Infection

PubMed Central

Wenisch, Judith M.; Schmid, Daniela; Kuo, Hung-Wei; Allerberger, Franz; Michl, Verena; Tesik, Philip; Tucek, Gerhard; Laferl, Hermann

2012-01-01

In a hospital-based, prospective cohort study, the effects of the three standard treatment regimens for mild Clostridium difficile infection (CDI), oral (p.o.) metronidazole at 500 mg three times/day, intravenous (i.v.) metronidazole at 500 mg three times/day, and oral (p.o.) vancomycin at 250 mg four times/day, were compared with respect to the risk of occurrence of complications, sequelae, and all-cause death within 30 days after the date of starting treatment. Differences in the incidence of these outcomes were tested by χ2 or Fisher's exact tests. A Poisson regression model was performed to control for possible confounding effects of sex, age, and severity of comorbidity categorized according to the Charlson comorbidity index. The highest mortality was observed in the metronidazole i.v. group, with a mortality rate 38.1% (16/42) compared to mortality rates of 7.4% (9/121) in the metronidazole p.o. group and 9.5% (4/42) in the vancomycin p.o. group (P < 0.001). After adjustment for possible effects of sex, age (>65 years), and severity of comorbidity, the relative risk of a 30-day fatal outcome for patients receiving metronidazole i.v. was 4.3 (95% confidence interval [CI] = 1.92 to 10; P < 0.0001) compared to patients treated with metronidazole p.o. and 4.0 (95% CI = 1.31 to 5.0; P < 0.015) compared to patients treated with vancomycin p.o. There were no significant differences in the risk of complications between the three treatment groups. This study generates the hypothesis that treatment with i.v. metronidazole is inferior to the oral alternatives metronidazole and vancomycin. PMID:22252830

Committing driving violations: an observational study comparing city, town and village.

PubMed

Rosenbloom, Tova; Ben-Eliyahu, Adar; Nemrodov, Dan; Biegel, Ariela; Perlman, Amotz

2009-01-01

This article compares observed driving behavior in a city, a town, and a village. Unobtrusive observations were made at intersections in each residential type. Five violation types were observed: (a) not wearing a seat belt (seat belt violation); (b) not using a safety seat for a child (safety seat violation for children); (c) not using a speaker while speaking on the phone (on-phone violation); (d) failing to comply with a 'give way' sign ('give way' sign violation); and (e) stopping in an undesignated area (undesignated stop violation). It was expected that in accordance with the anonymity hypothesis that the bigger residential areas' rate of traffic violations would be higher. The effects of the residential type, drivers' gender, and age were assessed using the multiple regression model. The stepwise method of evaluation was employed. The model converged on step 3 (Adjusted R square=0.039). Residential type and gender contributed significantly to the model. Consistent with prior research, male drivers committed more violations than female drivers. Chi-square analyses were used to test the distribution of violations by the settlement types. Overall, more drivers committed violations in the two small residential areas than in the city, with 30% of city drivers, 43% of town drivers, and 51% of village drivers committing at least one violation (chi2 (2)=37.65, p<0.001). Moreover, in the town and the village, a combination of one or more violations was committed more often than in the city(chi2 (1)=34.645, p<0.001). Accordingly, more drivers committed violations in the two small settlements (48.4%) than in the city (30.6%). Possible explanations for the observed results were provided in the Discussion section. The conclusions of this paper are that drivers in small villages tend to disobey traffic laws. Therefore, efforts have to be made in companies to take this issue in consideration while running fleets in companies located in small places far from the center.

Hemispheric Coupling: Comparing Dynamo Simulations and Observations

NASA Astrophysics Data System (ADS)

Norton, A. A.; Charbonneau, P.; Passos, D.

2014-12-01

Numerical simulations that reproduce solar-like magnetic cycles can be used to generate long-term statistics. The variations in north-south hemispheric solar cycle synchronicity and amplitude produced in simulations has not been widely compared to observations. The observed limits on solar cycle amplitude and phase asymmetry show that hemispheric sunspot area production is no more than 20 % asymmetric for cycles 17-23 and that phase lags do not exceed 20 % (or two years) of the total cycle period, as determined from Royal Greenwich Observatory sunspot data. Several independent studies have found a long-term trend in phase values as one hemisphere leads the other for, on average, four cycles. Such persistence in phase is not indicative of a stochastic phenomenon. We compare these observational findings to the magnetic cycle found in a numerical simulation of solar convection recently produced with the EULAG-MHD model. This long "millennium simulation" spans more than 1600 years and generated 40 regular, sunspot-like cycles. While the simulated cycle length is too long (˜40 yrs) and the toroidal bands remain at too high of latitudes (>30°), some solar-like aspects of hemispheric asymmetry are reproduced. The model is successful at reproducing the synchrony of polarity inversions and onset of cycle as the simulated phase lags do not exceed 20 % of the cycle period. The simulated amplitude variations between the north and south hemispheres are larger than those observed in the Sun, some up to 40 %. An interesting note is that the simulations also show that one hemisphere can persistently lead the other for several successive cycles, placing an upper bound on the efficiency of transequatorial magnetic coupling mechanisms. These include magnetic diffusion, cross-equatorial mixing within latitudinally-elongated convective rolls (a.k.a. "banana cells") and transequatorial meridional flow cells. One or more of these processes may lead to magnetic flux cancellation whereby

Are Common Skin Diseases among Norwegian Dermatological Outpatients Associated with Psychological Problems Compared with Controls? An Observational Study.

PubMed

Balieva, Flora; Lien, Lars; Kupfer, Jörg; Halvorsen, Jon Anders; Dalgard, Florence

2016-02-01

Dermatological disease has been shown to be associated with psychological comorbidity. The aim of this observational study is to describe the distribution of skin disease and the prevalence of depression, anxiety and stress among Norwegian dermatological outpatients. Thirteen percent of outpatients had clinical anxiety compared with 3.7% of healthy controls, and 5.8% had clinical depression compared with 0.9% of controls. Adjusted odds ratio for clinical anxiety was 4.53 in patients compared with controls, and for clinical depression 6.25, which is much higher than previously described in a larger European study. Patients with tumours had less depression. Chronic inflammatory skin conditions had an especially high impact on patient's psychological wellbeing and should not be undervalued relative to, for instance, skin cancer in health strategies. These results argue strongly for including skin disease prevention and treatment in future health strategies.

Clinical efficacy of polyspecific intravenous immunoglobulin therapy in patients with streptococcal toxic shock syndrome: a comparative observational study.

PubMed

Linnér, Anna; Darenberg, Jessica; Sjölin, Jan; Henriques-Normark, Birgitta; Norrby-Teglund, Anna

2014-09-15

Streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis are the 2 most severe invasive manifestations caused by group A Streptococcus (GAS). Intravenous immunoglobulin (IVIG) therapy has been suggested as adjunctive treatment with a beneficial effect on mortality. However the clinical evidence is limited. Here we aim to further document the clinical efficacy of administered IVIG therapy in a comparative observational study of well-defined patients with STSS. The effect of IVIG was evaluated in patients with STSS prospectively identified in a nationwide Swedish surveillance study conducted between April 2002 and December 2004. Detailed data on symptoms, severity of disease, treatment, and outcome were obtained from 67 patients. Crude and adjusted analyses with logistic regression were performed. Twenty-three patients received IVIG therapy compared with 44 who did not. No significant difference in comorbidities, severity of disease, organ failures, or sex was seen, but the IVIG group was slightly younger and had a higher degree of necrotizing fasciitis (56% vs 14%). The primary endpoint was 28-day survival. Adjusted analysis revealed that factors influencing survival in STSS were Simplified Acute Physiology Score II (odds ratio [OR], 1.1; P = .007), clindamycin (OR, 8.6; P = .007), and IVIG (OR, 5.6; P = .030). This comparative observational study of prospectively identified STSS patients demonstrates that both IVIG and clindamycin therapy contribute to a significantly improved survival in STSS. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Effect of accreditation on the quality of chronic disease management: a comparative observational study.

PubMed

van Doorn-Klomberg, Arna L; Braspenning, Jozé C C; Wolters, René J; Bouma, Margriet; Wensing, Michel

2014-11-04

Practice accreditation is widely used to assess and improve quality of healthcare providers. Little is known about its effectiveness, particularly in primary care. In this study we examined the effect of accreditation on quality of care regarding diabetes, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). A comparative observational study with two cohorts was performed. We included 138 Dutch family practices that participated in the national accreditation program for primary care. A first cohort of 69 practices was measured at start and completion of a 3-year accreditation program. A second cohort of 69 practices was included and measured simultaneously with the final measurement of the first cohort. In separate multilevel regression analyses, we compared both within-group changes in the first cohort and between-groups differences at follow-up (first cohort) and start (second cohort). Outcome measures consisted of 24 systematically developed indicators of quality of care in targeted chronic diseases. In the within-group comparison, we found improvements on 6 indicators related to diabetes (feet examination, cholesterol measurement, lipid lowering medication prescription) and COPD (spirometry performance, stop smoking advice). In the between-groups comparison we found that first cohort practices performed better on 4 indicators related to diabetes (cholesterol outcome) and CVD (blood pressure outcome, smoke status registration, glucose measurement). Improvements of the quality of primary care for patients with chronic diseases were found, but few could be attributed to the accreditation program. Further development of accreditation is needed to enhance its effectiveness on chronic disease management.

Observational Study Designs for Comparative Effectiveness Research: An Alternative Approach to Close Evidence Gaps in Head-and-Neck Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goulart, Bernardo H.L., E-mail: bhg@uw.edu; University of Washington, Seattle, Washington; Ramsey, Scott D.

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H and N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H and N RCTs, which limits the validity of their results to the broader H and N cancer patient population seenmore » in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H and N cancer, including treatment comparisons for rare types of H and N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H and N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H and N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design.« less

Observational study designs for comparative effectiveness research: an alternative approach to close evidence gaps in head-and-neck cancer.

PubMed

Goulart, Bernardo H L; Ramsey, Scott D; Parvathaneni, Upendra

2014-01-01

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H&N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H&N RCTs, which limits the validity of their results to the broader H&N cancer patient population seen in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H&N cancer, including treatment comparisons for rare types of H&N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H&N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H&N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design. Copyright © 2014 Elsevier Inc. All rights reserved.

Expanding the Evidence Base: Comparing Randomized Controlled Trials and Observational Studies of Statins.

PubMed

Atar, Dan; Ong, Seleen; Lansberg, Peter J

2015-01-01

It is widely accepted that randomized controlled trials (RCTs) are the gold standard for demonstrating the efficacy of a given therapy (results under ideal conditions). Observational studies, on the other hand, can complement this by demonstrating effectiveness (results under real-world conditions). To examine the role that observational studies can play in complementing data from RCTs, we reviewed published studies for statins, a class of drugs that have been widely used to reduce the risk of cardiovascular (CV) events by lowering low-density lipoprotein cholesterol levels. RCTs have consistently demonstrated the benefits of statin treatment in terms of CV risk reduction and have demonstrated that more intensive statin therapy has incremental benefits over less intensive treatment. Observational studies of statin use in 'real-world' populations have served to augment the evidence base generated from statin RCTs in preselected populations of patients who are often at high CV risk and have led to similar safety and efficacy findings. They have also raised questions about factors affecting medication adherence, under-treatment, switching between statins, and failure to reach low-density lipoprotein cholesterol target levels, questions for which the answers could lead to improved patient care.

Comparing Two Approaches for Assessing Observation Impact

NASA Technical Reports Server (NTRS)

Todling, Ricardo

2013-01-01

Langland and Baker introduced an approach to assess the impact of observations on the forecasts. In that approach, a state-space aspect of the forecast is defined and a procedure is derived ultimately relating changes in the aspect with changes in the observing system. Some features of the state-space approach are to be noted: the typical choice of forecast aspect is rather subjective and leads to incomplete assessment of the observing system, it requires availability of a verification state that is in practice correlated with the forecast, and it involves the adjoint operator of the entire data assimilation system and is thus constrained by the validity of this operator. This article revisits the topic of observation impacts from the perspective of estimation theory. An observation-space metric is used to allow inferring observation impact on the forecasts without the limitations just mentioned. Using differences of observation-minus-forecast residuals obtained from consecutive forecasts leads to the following advantages: (i) it suggests a rather natural choice of forecast aspect that directly links to the data assimilation procedure, (ii) it avoids introducing undesirable correlations in the forecast aspect since verification is done against the observations, and (iii) it does not involve linearization and use of adjoints. The observation-space approach has the additional advantage of being nearly cost free and very simple to implement. In its simplest form it reduces to evaluating the statistics of observationminus- background and observation-minus-analysis residuals with traditional methods. Illustrations comparing the approaches are given using the NASA Goddard Earth Observing System.

The role of observational investigations in comparative effectiveness research.

PubMed

Marko, Nicholas F; Weil, Robert J

2010-12-01

Comparative effectiveness research (CER) seeks to inform clinical decisions between alternate treatment strategies using data that reflects real patient populations and real-world clinical scenarios for the purpose of improving patient outcomes. There are multiple clinical situations where the unique characteristics of observational investigations can inform medical decision-making within the CER paradigm. Accordingly, it is critical for clinicians to appreciate the strengths and limitations of observational research, particularly as they apply to CER. This review focuses on the role of observational research in CER. We discuss the concept of evidence hierarchies as they relate to observational research and CER, review the scope and nature of observational research, present the rationale for its inclusion in CER investigations, discuss potential sources of bias in observational investigations as well as strategies used to compensate for these biases, and discuss a framework to implement observational research in CER. The CER paradigm recognizes the limitations of hierarchical models of evidence and favors application of a strength-of-evidence model. In this model, observational research fills gaps in randomized clinical trial data and is particularly valuable to investigate effectiveness, harms, prognosis, and infrequent outcomes as well as in circumstances where randomization is not possible and in studies of many surgical populations. Observational investigations must be designed with careful consideration of potential sources of bias and must incorporate strategies to control such bias prospectively, and their results must be reported in a uniform and transparent fashion. When these conditions can be achieved, observational research represents a valuable and critical component of modern CER. © 2010, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

The GRACE checklist for rating the quality of observational studies of comparative effectiveness: a tale of hope and caution.

PubMed

Dreyer, Nancy A; Velentgas, Priscilla; Westrich, Kimberly; Dubois, Robert

2014-03-01

While there is growing demand for information about comparative effectiveness (CE), there is substantial debate about whether and when observational studies have sufficient quality to support decision making. To develop and test an item checklist that can be used to qualify those observational CE studies sufficiently rigorous in design and execution to contribute meaningfully to the evidence base for decision support. An 11-item checklist about data and methods (the GRACE checklist) was developed through literature review and consultation with experts from professional societies, payer groups, the private sector, and academia. Since no single gold standard exists for validation, checklist item responses were compared with 3 different types of external quality ratings (N=88 articles). The articles compared treatment effectiveness and/or safety of drugs, medical devices, and medical procedures. We validated checklist item responses 3 ways against external quality ratings, using published articles of observational CE or safety studies: (a) Systematic Review-quality assessment from a published systematic review; (b) Single Expert Review-quality assessment made according to the solicited "expert opinion" of a senior researcher; and (c) Concordant Expert Review-quality assessments from 2 experts for which there was concordance. Volunteers (N=113) from 5 continents completed 280 article assessments using the checklist. Positive and negative predictive values (PPV, NPV, respectively) of individual items were estimated to compare testers' assessments with those of experts. Taken as a whole, the scale had better NPV than PPV, for both data and methods. The most consistent predictor of quality relates to the validity of the primary outcomes measurement for the study purpose. Other consistent markers of quality relate to using concurrent comparators, minimizing the effects of bias by prudent choice of covariates, and using sensitivity analysis to test robustness of results

The clinical course of low back pain: a meta-analysis comparing outcomes in randomised clinical trials (RCTs) and observational studies

PubMed Central

2014-01-01

Background Evidence suggests that the course of low back pain (LBP) symptoms in randomised clinical trials (RCTs) follows a pattern of large improvement regardless of the type of treatment. A similar pattern was independently observed in observational studies. However, there is an assumption that the clinical course of symptoms is particularly influenced in RCTs by mere participation in the trials. To test this assumption, the aim of our study was to compare the course of LBP in RCTs and observational studies. Methods Source of studies CENTRAL database for RCTs and MEDLINE, CINAHL, EMBASE and hand search of systematic reviews for cohort studies. Studies include individuals aged 18 or over, and concern non-specific LBP. Trials had to concern primary care treatments. Data were extracted on pain intensity. Meta-regression analysis was used to compare the pooled within-group change in pain in RCTs with that in cohort studies calculated as the standardised mean change (SMC). Results 70 RCTs and 19 cohort studies were included, out of 1134 and 653 identified respectively. LBP symptoms followed a similar course in RCTs and cohort studies: a rapid improvement in the first 6 weeks followed by a smaller further improvement until 52 weeks. There was no statistically significant difference in pooled SMC between RCTs and cohort studies at any time point:- 6 weeks: RCTs: SMC 1.0 (95% CI 0.9 to 1.0) and cohorts 1.2 (0.7to 1.7); 13 weeks: RCTs 1.2 (1.1 to 1.3) and cohorts 1.0 (0.8 to 1.3); 27 weeks: RCTs 1.1 (1.0 to 1.2) and cohorts 1.2 (0.8 to 1.7); 52 weeks: RCTs 0.9 (0.8 to 1.0) and cohorts 1.1 (0.8 to 1.6). Conclusions The clinical course of LBP symptoms followed a pattern that was similar in RCTs and cohort observational studies. In addition to a shared ‘natural history’, enrolment of LBP patients in clinical studies is likely to provoke responses that reflect the nonspecific effects of seeking and receiving care, independent of the study design. PMID:24607083

Making limb and nadir measurements comparable: A common volume study of PMC brightness observed by Odin OSIRIS and AIM CIPS

NASA Astrophysics Data System (ADS)

Benze, Susanne; Gumbel, Jörg; Randall, Cora E.; Karlsson, Bodil; Hultgren, Kristoffer; Lumpe, Jerry D.; Baumgarten, Gerd

2018-01-01

Combining limb and nadir satellite observations of Polar Mesospheric Clouds (PMCs) has long been recognized as problematic due to differences in observation geometry, scattering conditions, and retrieval approaches. This study offers a method of comparing PMC brightness observations from the nadir-viewing Aeronomy of Ice in the Mesosphere (AIM) Cloud Imaging and Particle Size (CIPS) instrument and the limb-viewing Odin Optical Spectrograph and InfraRed Imaging System (OSIRIS). OSIRIS and CIPS measurements are made comparable by defining a common volume for overlapping OSIRIS and CIPS observations for two northern hemisphere (NH) PMC seasons: NH08 and NH09. We define a scattering intensity quantity that is suitable for either nadir or limb observations and for different scattering conditions. A known CIPS bias is applied, differences in instrument sensitivity are analyzed and taken into account, and effects of cloud inhomogeneity and common volume definition on the comparison are discussed. Not accounting for instrument sensitivity differences or inhomogeneities in the PMC field, the mean relative difference in cloud brightness (CIPS - OSIRIS) is -102 ± 55%. The differences are largest for coincidences with very inhomogeneous clouds that are dominated by pixels that CIPS reports as non-cloud points. Removing these coincidences, the mean relative difference in cloud brightness reduces to -6 ± 14%. The correlation coefficient between the CIPS and OSIRIS measurements of PMC brightness variations in space and time is remarkably high, at 0.94. Overall, the comparison shows excellent agreement despite different retrieval approaches and observation geometries.

Validation: Codes to compare simulation data to various observations

NASA Astrophysics Data System (ADS)

Cohn, J. D.

2017-02-01

Validation provides codes to compare several observations to simulated data with stellar mass and star formation rate, simulated data stellar mass function with observed stellar mass function from PRIMUS or SDSS-GALEX in several redshift bins from 0.01-1.0, and simulated data B band luminosity function with observed stellar mass function, and to create plots for various attributes, including stellar mass functions, and stellar mass to halo mass. These codes can model predictions (in some cases alongside observational data) to test other mock catalogs.

Individual survival curves comparing subjective and observed mortality risks.

PubMed

Bissonnette, Luc; Hurd, Michael D; Michaud, Pierre-Carl

2017-12-01

We compare individual survival curves constructed from objective (actual mortality) and elicited subjective information (probability of survival to a given target age). We develop a methodology to estimate jointly subjective and objective individual survival curves accounting for rounding on subjective reports of perceived survival. We make use of the long follow-up period in the Health and Retirement Study and the high quality of mortality data to estimate individual survival curves that feature both observed and unobserved heterogeneity. This allows us to compare objective and subjective estimates of remaining life expectancy for various groups and compare welfare effects of objective and subjective mortality risk using the life cycle model of consumption. We find that subjective and objective hazards are not the same. The median welfare loss from misperceptions of mortality risk when annuities are not available is 7% of current wealth at age 65 whereas more than 25% of respondents have losses larger than 60% of wealth. When annuities are available and exogenously given, the welfare loss is substantially lower. Copyright © 2017 John Wiley & Sons, Ltd.

Vaginal birth after caesarean section prediction models: a UK comparative observational study.

PubMed

Mone, Fionnuala; Harrity, Conor; Mackie, Adam; Segurado, Ricardo; Toner, Brenda; McCormick, Timothy R; Currie, Aoife; McAuliffe, Fionnuala M

2015-10-01

Primarily, to assess the performance of three statistical models in predicting successful vaginal birth in patients attempting a trial of labour after one previous lower segment caesarean section (TOLAC). The statistically most reliable models were subsequently subjected to validation testing in a local antenatal population. A retrospective observational study was performed with study data collected from the Northern Ireland Maternity Service Database (NIMATs). The study population included all women that underwent a TOLAC (n=385) from 2010 to 2012 in a regional UK obstetric unit. Data was collected from the Northern Ireland Maternity Service Database (NIMATs). Area under the curve (AUC) and correlation analysis was performed. Of the three prediction models evaluated, AUC calculations for the Smith et al., Grobman et al. and Troyer and Parisi Models were 0.74, 0.72 and 0.65, respectively. Using the Smith et al. model, 52% of women had a low risk of caesarean section (CS) (predicted VBAC >72%) and 20% had a high risk of CS (predicted VBAC <60%), of whom 20% and 63% had delivery by CS. The fit between observed and predicted outcome in this study cohort using the Smith et al. and Grobman et al. models were greatest (Chi-square test, p=0.228 and 0.904), validating both within the population. The Smith et al. and Grobman et al. models could potentially be utilized within the UK to provide women with an informed choice when deciding on mode of delivery after a previous CS. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

Biases and systematics in the observational derivation of galaxy properties: comparing different techniques on synthetic observations of simulated galaxies

NASA Astrophysics Data System (ADS)

Guidi, Giovanni; Scannapieco, Cecilia; Walcher, C. Jakob

2015-12-01

We study the sources of biases and systematics in the derivation of galaxy properties from observational studies, focusing on stellar masses, star formation rates, gas and stellar metallicities, stellar ages, magnitudes and colours. We use hydrodynamical cosmological simulations of galaxy formation, for which the real quantities are known, and apply observational techniques to derive the observables. We also analyse biases that are relevant for a proper comparison between simulations and observations. For our study, we post-process the simulation outputs to calculate the galaxies' spectral energy distributions (SEDs) using stellar population synthesis models and also generate the fully consistent far-UV-submillimetre wavelength SEDs with the radiative transfer code SUNRISE. We compared the direct results of simulations with the observationally derived quantities obtained in various ways, and found that systematic differences in all studied galaxy properties appear, which are caused by: (1) purely observational biases, (2) the use of mass-weighted and luminosity-weighted quantities, with preferential sampling of more massive and luminous regions, (3) the different ways of constructing the template of models when a fit to the spectra is performed, and (4) variations due to different calibrations, most notably for gas metallicities and star formation rates. Our results show that large differences can appear depending on the technique used to derive galaxy properties. Understanding these differences is of primary importance both for simulators, to allow a better judgement of similarities and differences with observations, and for observers, to allow a proper interpretation of the data.

A prospective, observational study comparing the PK/PD relationships of generic Meropenem (Mercide®) to the innovator brand in critically ill patients.

PubMed

Mer, Mervyn; Snyman, Jacques Rene; van Rensburg, Constance Elizabeth Jansen; van Tonder, Jacob John; Laurens, Ilze

2016-01-01

Clinicians' skepticism, fueled by evidence of inferiority of some multisource generic antimicrobial products, results in the underutilization of more cost-effective generics, especially in critically ill patients. The aim of this observational study was to demonstrate equivalence between the generic or comparator brand of meropenem (Mercide ® ) and the leading innovator brand (Meronem ® ) by means of an ex vivo technique whereby antimicrobial activity is used to estimate plasma concentration of the active moiety. Patients from different high care and intensive care units were recruited for observation when prescribed either of the meropenem brands under investigation. Blood samples were collected over 6 hours after a 30 minute infusion of the different brands. Meropenem concentration curves were established against United States Pharmacopeia standard meropenem (Sigma-Aldrich) by using standard laboratory techniques for culture of Klebsiella pneumoniae. Patients' plasma samples were tested ex vivo, using a disc diffusion assay, to confirm antimicrobial activity and estimate plasma concentrations of the two brands. Both brands of meropenem demonstrated similar curves in donor plasma when concentrations in vials were confirmed. Patient-specific serum concentrations were determined from zones of inhibition against a standard laboratory Klebsiella strain ex vivo, confirming at least similar in vivo concentrations as the concentration curves (90% confidence interval) overlapped; however, the upper limit of the area under the curve for the ratio comparator/innovator exceeded the 1.25-point estimate, i.e., 4% higher for comparator meropenem. This observational, in-practice study demonstrates similar ex vivo activity and in vivo plasma concentration time curves for the products under observation. Assay sensitivity is also confirmed. Current registration status of generic small molecules is in place. The products are therefore clinically interchangeable based on

A prospective, observational study comparing the PK/PD relationships of generic Meropenem (Mercide®) to the innovator brand in critically ill patients

PubMed Central

Mer, Mervyn; Snyman, Jacques Rene; van Rensburg, Constance Elizabeth Jansen; van Tonder, Jacob John; Laurens, Ilze

2016-01-01

Introduction Clinicians’ skepticism, fueled by evidence of inferiority of some multisource generic antimicrobial products, results in the underutilization of more cost-effective generics, especially in critically ill patients. The aim of this observational study was to demonstrate equivalence between the generic or comparator brand of meropenem (Mercide®) and the leading innovator brand (Meronem®) by means of an ex vivo technique whereby antimicrobial activity is used to estimate plasma concentration of the active moiety. Methods Patients from different high care and intensive care units were recruited for observation when prescribed either of the meropenem brands under investigation. Blood samples were collected over 6 hours after a 30 minute infusion of the different brands. Meropenem concentration curves were established against United States Pharmacopeia standard meropenem (Sigma-Aldrich) by using standard laboratory techniques for culture of Klebsiella pneumoniae. Patients’ plasma samples were tested ex vivo, using a disc diffusion assay, to confirm antimicrobial activity and estimate plasma concentrations of the two brands. Results Both brands of meropenem demonstrated similar curves in donor plasma when concentrations in vials were confirmed. Patient-specific serum concentrations were determined from zones of inhibition against a standard laboratory Klebsiella strain ex vivo, confirming at least similar in vivo concentrations as the concentration curves (90% confidence interval) overlapped; however, the upper limit of the area under the curve for the ratio comparator/innovator exceeded the 1.25-point estimate, i.e., 4% higher for comparator meropenem. Conclusion This observational, in-practice study demonstrates similar ex vivo activity and in vivo plasma concentration time curves for the products under observation. Assay sensitivity is also confirmed. Current registration status of generic small molecules is in place. The products are therefore

Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings.

PubMed

Hopman, J; Hakizimana, B; Meintjes, W A J; Nillessen, M; de Both, E; Voss, A; Mehtar, S

2016-01-01

Hospital-associated infections (HAIs) are more frequently encountered in low- than in high-resource settings. There is a need to identify and implement feasible and sustainable approaches to strengthen HAI prevention in low-resource settings. To evaluate the biological contamination of routinely cleaned mattresses in both high- and low-resource settings. In this two-stage observational study, routine manual bed cleaning was evaluated at two university hospitals using adenosine triphosphate (ATP). Standardized training of cleaning personnel was achieved in both high- and low-resource settings. Qualitative analysis of the cleaning process was performed to identify predictors of cleaning outcome in low-resource settings. Mattresses in low-resource settings were highly contaminated prior to cleaning. Cleaning significantly reduced biological contamination of mattresses in low-resource settings (P < 0.0001). After training, the contamination observed after cleaning in both the high- and low-resource settings seemed comparable. Cleaning with appropriate type of cleaning materials reduced the contamination of mattresses adequately. Predictors for mattresses that remained contaminated in a low-resource setting included: type of product used, type of ward, training, and the level of contamination prior to cleaning. In low-resource settings mattresses were highly contaminated as noted by ATP levels. Routine manual cleaning by trained staff can be as effective in a low-resource setting as in a high-resource setting. We recommend a multi-modal cleaning strategy that consists of training of domestic services staff, availability of adequate time to clean beds between patients, and application of the correct type of cleaning products. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients.

PubMed

Armstrong, James; Forrest, Helen; Crawford, Mark W

2015-10-01

Discharge criteria based on physiological scoring systems can be used in the postanesthesia care unit (PACU) to fast-track patients after ambulatory surgery; however, studies comparing physiological scoring systems with traditional time-based discharge criteria are lacking. The purpose of this study was to compare PACU discharge readiness times using physiological vs time-based discharge criteria in pediatric ambulatory surgical patients. We recorded physiological observations from consecutive American Society of Anesthesiologists physical status I-III patients aged 1-18 yr who were admitted to the PACU after undergoing ambulatory surgery in a tertiary academic pediatric hospital. The physiological score was a combination of the Aldrete and Chung systems. Scores were recorded every 15 min starting upon arrival in the PACU. Patients were considered fit for discharge once they attained a score ≥12 (maximum score, 14), provided no score was zero, with the time to achieve a score ≥12 defining the criteria-based discharge (CBD) time. Patients were discharged from the PACU when both the CBD and the existing time-based discharge (TBD) criteria were met. The CBD and TBD data were compared using Kaplan-Meier and log-rank analysis. Observations from 506 children are presented. Median (interquartile range [IQR]) age was 5.5 [2.8-9.9] yr. Median [IQR] CBD and TBD PACU discharge readiness times were 30 [15-45] min and 60 [45-60] min, respectively. Analysis of Kaplan-Meier curves indicated a significant difference in discharge times using the different criteria (hazard ratio, 5.43; 95% confidence interval, 4.51 to 6.53; P < 0.001). All patients were discharged home without incident. This prospective study suggests that discharge decisions based on physiological criteria have the potential for significantly speeding the transit of children through the PACU, thereby enhancing PACU efficiency and resource utilization.

Learning by viewing versus learning by doing: A comparative study of observer and participant experiences during an interprofessional simulation training.

PubMed

Reime, Marit Hegg; Johnsgaard, Tone; Kvam, Fred Ivan; Aarflot, Morten; Engeberg, Janecke Merethe; Breivik, Marit; Brattebø, Guttorm

2017-01-01

Larger student groups and pressure on limited faculty time have raised the question of the learning value of merely observing simulation training in emergency medicine, instead of active team participation. The purpose of this study was to examine observers and hands-on participants' self-reported learning outcomes during simulation-based interprofessional team training regarding non-technical skills. In addition, we compared the learning outcomes for different professions and investigated team performance relative to the number of simulations in which they participated. A concurrent mixed-method design was chosen to evaluate the study, using questionnaires, observations, and focus group interviews. Participants included a total of 262 postgraduate and bachelor nursing students and medical students, organised into 44 interprofessional teams. The quantitative data showed that observers and participants had similar results in three of six predefined learning outcomes. The qualitative data emphasised the importance of participating in different roles, training several times, and training interprofessionally to enhance realism. Observing simulation training can be a valuable learning experience, but the students' preferred hands-on participation and learning by doing. For this reason, one can legitimise the observer role, given the large student groups and limited faculty time, as long as the students are also given some opportunity for hands-on participation in order to become more confident in their professional roles.

Comparing virtual consults to traditional consults using an electronic health record: an observational case–control study

PubMed Central

2012-01-01

Background Patients have typically received health care through face-to-face encounters. However, expansion of electronic communication and electronic health records (EHRs) provide alternative means for patient and physicians to interact. Electronic consultations may complement regular healthcare by providing “better, faster, cheaper” processes for diagnosing, treating, and monitoring health conditions. Virtual consultation between physicians may provide a method of streamlining care, potentially saving patients the time and expense of added visits. The purpose of this study was to compare physician usage and patient satisfaction with virtual consultations (VCs) with traditional consultations (TCs) facilitated within an EHR. Methods We conducted an observational case–control survey study within Kaiser Permanente, Colorado. A sample of patients who had VCs requested by physicians (N = 270) were matched with patients who had TCs requested by physicians (N = 270), by patient age, gender, reason for the consult, and specialty department. These patients (VC and TC), were invited to participate in a satisfaction survey. In addition, 205 primary care physicians who submitted a VC or TC were surveyed. Results During the study period, 58,146 VC or TC were requested (TC = 96.3%). Patients who completed a satisfaction survey (267 out of 540 patients, 49.4% response rate) indicated they were satisfied with their care, irrespective of the kind of consult (mean 10-point Likert score of 8.5). 88 of 205 primary care physicians surveyed (42.9%) returned at least one survey; VC and TC survey response rates and consulted departments were comparable (p = 0.13). More TCs than VCs requested transfer of patient care (p = 0.03), assistance with diagnosis (p = 0.04) or initiating treatment (p =0.04). Within 3 weeks of the consultation request, 72.1% of respondents reported receiving information from VCs, compared with 33.9% of the TCs (p < 0.001). Utility of information provided by

Using non-specialist observers in 4AFC human observer studies

NASA Astrophysics Data System (ADS)

Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

2017-03-01

Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

Observing Protein & Energy Nutrition (OPEN) Study

Cancer.gov

The Observing Protein and Energy Nutrition (OPEN) Study was designed to assess dietary measurement error by comparing results from self-reported dietary intake data with four dietary biomarkers: doubly labeled water and urinary nitrogen, sodium, and potassium.

Health-Risk Behaviour in Deprived Neighbourhoods Compared with Non-Deprived Neighbourhoods: A Systematic Literature Review of Quantitative Observational Studies.

PubMed

Algren, Maria Holst; Bak, Carsten Kronborg; Berg-Beckhoff, Gabriele; Andersen, Pernille Tanggaard

2015-01-01

There has been increasing interest in neighbourhoods' influence on individuals' health-risk behaviours, such as smoking, alcohol consumption, physical activity and diet. The aim of this review was to systematically review recent studies on health-risk behaviour among adults who live in deprived neighbourhoods compared with those who live in non-deprived neighbourhoods and to summarise what kind of operationalisations of neighbourhood deprivation that were used in the studies. PRISMA guidelines for systematic reviews were followed. Systematic searches were performed in PubMed, Embase, Web of Science and Sociological Abstracts using relevant search terms, Boolean operators, and truncation, and reference lists were scanned. Quantitative observational studies that examined health-risk behaviour in deprived neighbourhoods compared with non-deprived neighbourhoods were eligible for inclusion. The inclusion criteria were met by 22 studies. The available literature showed a positive association between smoking and physical inactivity and living in deprived neighbourhoods compared with non-deprived neighbourhoods. In regard to low fruit and vegetable consumption and alcohol consumption, the results were ambiguous, and no clear differences were found. Numerous different operationalisations of neighbourhood deprivation were used in the studies. Substantial evidence indicates that future health interventions in deprived neighbourhoods should focus on smoking and physical inactivity. We suggest that alcohol interventions should be population based rather than based on the specific needs of deprived neighbourhoods. More research is needed on fruit and vegetable consumption. In future studies, the lack of a uniform operationalisation of neighbourhood deprivation must be addressed.

Web-based Reanalysis Intercomparison Tools (WRIT): Comparing Reanalyses and Observational data.

NASA Astrophysics Data System (ADS)

Compo, G. P.; Smith, C. A.; Hooper, D. K.

2014-12-01

While atmospheric reanalysis datasets are widely used in climate science, many technical issues hinder comparing them to each other and to observations. The reanalysis fields are stored in diverse file architectures, data formats, and resolutions, with metadata, such as variable name and units, that also differ. Individual users have to download the fields, convert them to a common format, store them locally, change variable names, re-grid if needed, and convert units. Comparing reanalyses with observational datasets is difficult for similar reasons. Even if a dataset can be read via Open-source Project for a Network Data Access Protocol (OPeNDAP) or a similar protocol, most of this work is still needed. All of these tasks take time, effort, and money. To overcome some of the obstacles in reanalysis intercomparison, our group at the Cooperative Institute for Research in the Environmental Sciences (CIRES) at the University of Colorado and affiliated colleagues at National Oceanic and Atmospheric Administration's (NOAA's) Earth System Research Laboratory Physical Sciences Division (ESRL/PSD) have created a set of Web-based Reanalysis Intercomparison Tools (WRIT) at http://www.esrl.noaa.gov/psd/data/writ/. WRIT allows users to easily plot and compare reanalysis and observational datasets, and to test hypotheses. Currently, there are tools to plot monthly mean maps and vertical cross-sections, timeseries, and trajectories for standard pressure level and surface variables. Users can refine dates, statistics, and plotting options. Reanalysis datasets currently available include the NCEP/NCAR R1, NCEP/DOE R2, MERRA, ERA-Interim, NCEP CFSR and the 20CR. Observational datasets include those containing precipitation (e.g. GPCP), temperature (e.g. GHCNCAMS), winds (e.g. WASWinds), precipitable water (e.g. NASA NVAP), SLP (HadSLP2), and SST (NOAA ERSST). WRIT also facilitates the mission of the Reanalyses.org website as a convenient toolkit for studying the reanalysis datasets.

Addressing unmeasured confounding in comparative observational research.

PubMed

Zhang, Xiang; Faries, Douglas E; Li, Hu; Stamey, James D; Imbens, Guido W

2018-04-01

Observational pharmacoepidemiological studies can provide valuable information on the effectiveness or safety of interventions in the real world, but one major challenge is the existence of unmeasured confounder(s). While many analytical methods have been developed for dealing with this challenge, they appear under-utilized, perhaps due to the complexity and varied requirements for implementation. Thus, there is an unmet need to improve understanding the appropriate course of action to address unmeasured confounding under a variety of research scenarios. We implemented a stepwise search strategy to find articles discussing the assessment of unmeasured confounding in electronic literature databases. Identified publications were reviewed and characterized by the applicable research settings and information requirements required for implementing each method. We further used this information to develop a best practice recommendation to help guide the selection of appropriate analytical methods for assessing the potential impact of unmeasured confounding. Over 100 papers were reviewed, and 15 methods were identified. We used a flowchart to illustrate the best practice recommendation which was driven by 2 critical components: (1) availability of information on the unmeasured confounders; and (2) goals of the unmeasured confounding assessment. Key factors for implementation of each method were summarized in a checklist to provide further assistance to researchers for implementing these methods. When assessing comparative effectiveness or safety in observational research, the impact of unmeasured confounding should not be ignored. Instead, we suggest quantitatively evaluating the impact of unmeasured confounding and provided a best practice recommendation for selecting appropriate analytical methods. Copyright © 2018 John Wiley & Sons, Ltd.

In-utero exposure to metformin for type 2 diabetes or polycystic ovary syndrome: A prospective comparative observational study.

PubMed

Diav-Citrin, Orna; Steinmetz-Shoob, Salit; Shechtman, Svetlana; Ornoy, Asher

2018-05-29

To evaluate the rate of major anomalies after first trimester (T1)-metformin exposure. Comparative, observational cohort study done at the Israeli Teratology Information Service between 2000 and 2013. 170 T1-metformin-exposed pregnancies [119 for diabetes and 51 for polycystic ovary syndrome (PCOS)] were prospectively followed-up and compared with 93 pregnancies of T1-insulin treated women and 530 non-teratogenic exposed (NTE) pregnancies. The differences in the rate of major anomalies excluding genetic/cytogenetic, and spontaneously resolved cardiovascular anomalies were not significant [4.4% (2/45) - metformin-PCOS, 1.1% (1/90) - metformin-diabetes, 2.5% (2/80) - insulin, and 1.7% (9/519) - NTE; OR adj metformin / NTE 1.77; 95% CI 0.45-7.01; OR adj insulin / NTE 1.69; 95% CI 0.35-8.11]. The rate of Cesarean section was higher in both the metformin-diabetes 51/90 (56.7%) and insulin 45/79 (57.0%) groups compared with the NTE group [138/503 (27.4%)]. Metformin-T1-exposure per se is not associated with an increased risk of major anomalies. Copyright © 2018 Elsevier Inc. All rights reserved.

Lung ultrasound compared with chest X-ray in diagnosing postoperative pulmonary complications following cardiothoracic surgery: a prospective observational study.

PubMed

Touw, H R; Parlevliet, K L; Beerepoot, M; Schober, P; Vonk, A; Twisk, J W; Elbers, P W; Boer, C; Tuinman, P R

2018-03-12

Postoperative pulmonary complications are common after cardiothoracic surgery and are associated with adverse outcomes. The ability to detect postoperative pulmonary complications using chest X-rays is limited, and this technique requires radiation exposure. Little is known about the diagnostic accuracy of lung ultrasound for the detection of postoperative pulmonary complications after cardiothoracic surgery, and we therefore aimed to compare lung ultrasound with chest X-ray to detect postoperative pulmonary complications in this group of patients. We performed this prospective, observational, single-centre study in a tertiary intensive care unit treating adult patients who had undergone cardiothoracic surgery. We recorded chest X-ray findings upon admission and on postoperative days 2 and 3, as well as rates of postoperative pulmonary complications and clinically-relevant postoperative pulmonary complications that required therapy according to the treating physician as part of their standard clinical practice. Lung ultrasound was performed by an independent researcher at the time of chest X-ray. We compared lung ultrasound with chest X-ray for the detection of postoperative pulmonary complications and clinically-relevant postoperative pulmonary complications. We also assessed inter-observer agreement for lung ultrasound, and the time to perform both imaging techniques. Subgroup analyses were performed to compare the time to detection of clinically-relevant postoperative pulmonary complications by both modalities. We recruited a total of 177 patients in whom both lung ultrasound and chest X-ray imaging were performed. Lung ultrasound identified 159 (90%) postoperative pulmonary complications on the day of admission compared with 107 (61%) identified with chest X-ray (p < 0.001). Lung ultrasound identified 11 out of 17 patients (65%) and chest X-ray 7 out of 17 patients (41%) with clinically-relevant postoperative pulmonary complications (p < 0.001). The

Live versus Video Observations: Comparing the Reliability and Validity of Two Methods of Assessing Classroom Quality

ERIC Educational Resources Information Center

Curby, Timothy W.; Johnson, Price; Mashburn, Andrew J.; Carlis, Lydia

2016-01-01

When conducting classroom observations, researchers are often confronted with the decision of whether to conduct observations live or by using pre-recorded video. The present study focuses on comparing and contrasting observations of live and video administrations of the Classroom Assessment Scoring System-PreK (CLASS-PreK). Associations between…

Multi-institutional, prospective, observational study comparing the Gastrografin challenge versus standard treatment in adhesive small bowel obstruction.

PubMed

Zielinski, Martin D; Haddad, Nadeem N; Cullinane, Daniel C; Inaba, Kenji; Yeh, Dante D; Wydo, Salina; Turay, David; Pakula, Andrea; Duane, Therese M; Watras, Jill; Widom, Kenneth A; Cull, John; Rodriguez, Carlos J; Toschlog, Eric A; Sams, Valerie G; Hazelton, Joshua P; Graybill, John Christopher; Skinner, Ruby; Yune, Ji-Ming

2017-07-01

Existing trials studying the use of Gastrografin for management of adhesive small bowel obstruction (SBO) are limited by methodological flaws and small sample sizes. We compared institutional protocols with and without Gastrografin (GG), hypothesizing that a SBO management protocol utilizing GG is associated with lesser rates of exploration, shorter length of stay, and fewer complications. A multi-institutional, prospective, observational study was performed on patients appropriate for GG with adhesive SBO. Exclusion criteria were internal/external hernia, signs of strangulation, history of abdominal/pelvic malignancy, or exploration within the past 6 weeks. Patients receiving GG were compared to patients receiving standard care without GG. Overall, 316 patients were included (58 ± 18 years; 53% male). There were 173 (55%) patients in the GG group (of whom 118 [75%] successfully passed) and 143 patients in the non-GG group. There were no differences in duration of obstipation (1.6 vs. 1.9 days, p = 0.77) or small bowel feces sign (32.9% vs. 25.0%, p = 0.14). Fewer patients in the GG protocol cohort had mesenteric edema on CT (16.3% vs. 29.9%; p = 0.009). There was a lower rate of bowel resection (6.9% vs. 21.0%, p < 0.001) and exploration rate in the GG group (20.8% vs. 44.1%, p < 0.0001). GG patients had a shorter duration of hospital stay (4 IQR 2-7 vs. 5 days IQR 2-12; p = 0.036) and a similar rate of complications (12.5% vs. 17.9%; p = 0.20). Multivariable analysis revealed that GG was independently associated with successful nonoperative management. Patients receiving Gastrografin for adhesive SBO had lower rates of exploration and shorter hospital length of stay compared to patients who did not receive GG. Adequately powered and well-designed randomized trials are required to confirm these findings and establish causality. Therapeutic, level III.

European Adrenal Insufficiency Registry (EU-AIR): a comparative observational study of glucocorticoid replacement therapy.

PubMed

Ekman, Bertil; Fitts, David; Marelli, Claudio; Murray, Robert D; Quinkler, Marcus; Zelissen, Pierre M J

2014-05-09

Increased morbidity and mortality associated with conventional glucocorticoid replacement therapy for primary adrenal insufficiency (primary AI; estimated prevalence 93-140/million), secondary AI (estimated prevalence, 150-280/million, respectively) or congenital adrenal hyperplasia (estimated prevalence, approximately 65/million) may be due to the inability of typical glucocorticoid treatment regimens to reproduce the normal circadian profile of plasma cortisol. A once-daily modified-release formulation of hydrocortisone has been developed to provide a plasma cortisol profile that better mimics the daytime endogenous profile of cortisol. Here, we describe the protocol for the European Adrenal Insufficiency Registry (EU-AIR), an observational study to assess the long-term safety of modified-release hydrocortisone compared with conventional glucocorticoid replacement therapies in routine clinical practice (ClinicalTrials.gov identifier: NCT01661387). Patients enrolled in EU-AIR have primary or secondary AI and are receiving either modified-release or conventional glucocorticoid replacement therapy. The primary endpoints of EU-AIR are the incidence of intercurrent illness, adrenal crisis and serious adverse events (SAEs), as well as the duration of SAEs and dose changes related to SAEs. Data relating to morbidity, mortality, adverse drug reactions, dosing and concomitant therapies will be collected. Patient diaries will record illness-related dose changes between visits. All decisions concerning medical care are made by the registry physician and patient. Enrolment is targeted at achieving 3600 patient-years of treatment (1800 patient-years per group) for the primary analysis, which is focused on determining the non-inferiority of once-daily modified-release replacement therapy compared with conventional glucocorticoid therapy. Recruitment began in August 2012 and, as of March 2014, 801 patients have been enrolled. Fifteen centres are participating in Germany, the UK

Comparative Study of Three Reconnection X-Line Models at the Earth's Dayside Magnetopause Using In Situ Observations

NASA Astrophysics Data System (ADS)

Souza, V. M. C. E. S.; Gonzalez, W.; Sibeck, D. G.; Koga, D.; Walsh, B.; Mendes, O., Jr.

2017-12-01

This work examines the large-scale aspects of magnetic field reconnection at the Earth's dayside magnetopause. We use two sets of reconnection events, which are identified mostly by the in situ detection of accelerated and Alfvénic plasma flows. We intercompare three analytical models that predict the reconnection X-line location and orientation, namely the Trattner et al., (2007) and Swisdak and Drake (2007) models, and also a modified version of the component merging model (Gonzalez and Mozer 1974, Sonnerup 1974). In the first set of reconnection observations, we show three fortuitous, quasi-simultaneous dayside magnetopause crossing events where two widely separated spacecraft detect reconnection signatures, and the X-line location and orientation can be inferred from the observations. We compare X-line model predictions to those inferred from observations. These three reconnection events indicate the presence of an extended (>7 Earth radii in length), component-type reconnection X-line on Earth's dayside magnetopause connecting and structuring the reconnection signatures at locations far apart. In the second set of reconnection events, we analyze the X-line models' performance in predicting the observed reconnection outflow direction, i.e., its north-south and/or east-west senses, in a total of 75 single, rather than multiple and quasi-simultaneous, magnetopause crossing events, where reconnection-associated plasma flows were clearly present. We found that the Swisdak and Drake's (2007) X-line model performs slightly better, albeit not statistically significant, when predicting both accelerated plasma flow north-south and east-west components in 73% and 53% of the cases, respectively, as compared to the Trattner et al., (2007) model (70% north-south, 42% east-west), and the modified component merging model (66% north-south, 50% east-west).

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship-Observational Studies.

PubMed

Snyder, Graham M; Young, Heather; Varman, Meera; Milstone, Aaron M; Harris, Anthony D; Munoz-Price, Silvia

2016-10-01

Observational studies compare outcomes among subjects with and without an exposure of interest, without intervention from study investigators. Observational studies can be designed as a prospective or retrospective cohort study or as a case-control study. In healthcare epidemiology, these observational studies often take advantage of existing healthcare databases, making them more cost-effective than clinical trials and allowing analyses of rare outcomes. This paper addresses the importance of selecting a well-defined study population, highlights key considerations for study design, and offers potential solutions including biostatistical tools that are applicable to observational study designs. Infect Control Hosp Epidemiol 2016;1-6.

Comparing groundwater recharge and storage variability from GRACE satellite observations with observed water levels and recharge model simulations

NASA Astrophysics Data System (ADS)

Allen, D. M.; Henry, C.; Demon, H.; Kirste, D. M.; Huang, J.

2011-12-01

Sustainable management of groundwater resources, particularly in water stressed regions, requires estimates of groundwater recharge. This study in southern Mali, Africa compares approaches for estimating groundwater recharge and understanding recharge processes using a variety of methods encompassing groundwater level-climate data analysis, GRACE satellite data analysis, and recharge modelling for current and future climate conditions. Time series data for GRACE (2002-2006) and observed groundwater level data (1982-2001) do not overlap. To overcome this problem, GRACE time series data were appended to the observed historical time series data, and the records compared. Terrestrial water storage anomalies from GRACE were corrected for soil moisture (SM) using the Global Land Data Assimilation System (GLDAS) to obtain monthly groundwater storage anomalies (GRACE-SM), and monthly recharge estimates. Historical groundwater storage anomalies and recharge were determined using the water table fluctuation method using observation data from 15 wells. Historical annual recharge averaged 145.0 mm (or 15.9% of annual rainfall) and compared favourably with the GRACE-SM estimate of 149.7 mm (or 14.8% of annual rainfall). Both records show lows and peaks in May and September, respectively; however, the peak for the GRACE-SM data is shifted later in the year to November, suggesting that the GLDAS may poorly predict the timing of soil water storage in this region. Recharge simulation results show good agreement between the timing and magnitude of the mean monthly simulated recharge and the regional mean monthly storage anomaly hydrograph generated from all monitoring wells. Under future climate conditions, annual recharge is projected to decrease by 8% for areas with luvisols and by 11% for areas with nitosols. Given this potential reduction in groundwater recharge, there may be added stress placed on an already stressed resource.

An Observational Study of Antibiotic Prescribing Behavior and the Hawthorne Effect

PubMed Central

Mangione-Smith, Rita; Elliott, Marc N; McDonald, Laurie; McGlynn, Elizabeth A

2002-01-01

Objectives To assess whether prospective, observational study procedures, including questionnaires and audio recording, are associated with different patterns of physician diagnostic decision making and antibiotic prescribing. Data Sources/Setting (1) Survey data from a prospective observational study of treatment patterns for children with acute upper respiratory illnesses (10/96–3/97) and (2) retrospective medical record abstraction data of nonobserved encounters for the same problems occurring during (10/96–3/97) and one year after (10/97–3/98) the observational study period. Ten pediatricians in two community practices were studied. Study Design Patterns of diagnoses recorded in the medical record and antibiotics ordered for visits occurring outside of the observational study (same time period and one year later) were compared with the pattern of diagnoses and antibiotics ordered during the observational study. Data Collection/Extraction Methods For the observational study (10/96–2/97), diagnosis and treatment choices were obtained from questionnaires completed by physicians immediately following the visit. For the nonstudy encounters (10/96–3/97 and 10/97–3/98), data were abstracted from medical records one year after the observational study was completed. Principal Findings The proportion of viral cases in which an antibiotic was prescribed was 29 percentage points lower for the observational study compared to the retrospective analysis (p <.05). In one of two study sites, the proportion of cases assigned a bacterial diagnosis was 29 percentage points lower in the observational study period compared to the retrospective study (p <.05). Conclusions Observational study procedures including questionnaires and audio recording can affect antibiotic prescribing behavior. Future observational studies aimed at examining the frequency of inappropriate antibiotic prescribing should measure and adjust for the Hawthorne effect; without such adjustments, the

Anatomical knowledge gain through a clay-modeling exercise compared to live and video observations.

PubMed

Kooloos, Jan G M; Schepens-Franke, Annelieke N; Bergman, Esther M; Donders, Rogier A R T; Vorstenbosch, Marc A T M

2014-01-01

Clay modeling is increasingly used as a teaching method other than dissection. The haptic experience during clay modeling is supposed to correspond to the learning effect of manipulations during exercises in the dissection room involving tissues and organs. We questioned this assumption in two pretest-post-test experiments. In these experiments, the learning effects of clay modeling were compared to either live observations (Experiment I) or video observations (Experiment II) of the clay-modeling exercise. The effects of learning were measured with multiple choice questions, extended matching questions, and recognition of structures on illustrations of cross-sections. Analysis of covariance with pretest scores as the covariate was used to elaborate the results. Experiment I showed a significantly higher post-test score for the observers, whereas Experiment II showed a significantly higher post-test score for the clay modelers. This study shows that (1) students who perform clay-modeling exercises show less gain in anatomical knowledge than students who attentively observe the same exercise being carried out and (2) performing a clay-modeling exercise is better in anatomical knowledge gain compared to the study of a video of the recorded exercise. The most important learning effect seems to be the engagement in the exercise, focusing attention and stimulating time on task. © 2014 American Association of Anatomists.

Stool frequency recording in severe acute malnutrition ('StoolSAM'); an agreement study comparing maternal recall versus direct observation using diapers.

PubMed

Voskuijl, Wieger; Potani, Isabel; Bandsma, Robert; Baan, Anne; White, Sarah; Bourdon, Celine; Kerac, Marko

2017-06-07

Approximately 50% of the deaths of children under the age of 5 can be attributed to undernutrition, which also encompasses severe acute malnutrition (SAM). Diarrhoea is strongly associated with these deaths and is commonly diagnosed solely based on stool frequency and consistency obtained through maternal recall. This trial aims to determine whether this approach is equivalent to a 'directly observed method' in which a health care worker directly observed stool frequency using diapers in hospitalised children with complicated SAM. This study was conducted at 'Moyo' Nutritional Rehabilitation Unit, Queen Elizabeth Central Hospital, Malawi. Participants were children aged 5-59 months admitted with SAM. We compared 2 days of stool frequency data obtained with next-day maternal-recall versus a 'gold standard' in which a health care worker observed stool frequency every 2 h using diapers. After study completion, guardians were asked their preferred method and their level of education. We found poor agreement between maternal recall and the 'gold standard' of directly observed diapers. The sensitivity to detect diarrhoea based on maternal recall was poor, with only 75 and 56% of diarrhoea cases identified on days 1 and 2, respectively. However, the specificity was higher with more than 80% of children correctly classified as not having diarrhoea. On day 1, the mean stool frequency difference between the two methods was -0.17 (SD; 1.68) with limits of agreement (of stool frequency) of -3.55 and 3.20 and, similarly on day 2, the mean difference was -0.2 (SD; 1.59) with limits of agreement of -3.38 and 2.98. These limits extend beyond the pre-specified 'acceptable' limits of agreement (±1.5 stool per day) and indicate that the 2 methods are non-equivalent. The higher the stool frequency, the more discrepant the two methods were. Most primary care givers strongly preferred using diapers. This study shows lack of agreement between the assessment of stool frequency in SAM

Trends in mortality from 1965 to 2008 across the English north-south divide: comparative observational study

PubMed Central

Muller, Sara; Buchan, Iain E

2011-01-01

Objective To compare all cause mortality between the north and south of England over four decades. Design Population wide comparative observational study of mortality. Setting Five northernmost and four southernmost English government office regions. Population All residents in each year from 1965 to 2008. Main outcome measures Death rate ratios of north over south England by age band and sex, and northern excess mortality (percentage of excess deaths in north compared with south, adjusted for age and sex and examined for annual trends, using Poisson regression). Results During 1965 to 2008 the northern excess mortality remained substantial, at an average of 13.8% (95% confidence interval 13.7% to 13.9%). This geographical inequality was significantly larger for males than for females (14.9%, 14.7% to 15.0% v 12.7%, 12.6% to 12.9%, P<0.001). The inequality decreased significantly but temporarily for both sexes from the early 80s to the late 90s, followed by a steep significant increase from 2000 to 2008. Inequality varied with age, being higher for ages 0-9 years and 40-74 years and lower for ages 10-39 years and over 75 years. Time trends also varied with age. The strongest trend over time by age group was the increase among the 20-34 age group, from no significant northern excess mortality in 1965-95 to 22.2% (18.7% to 26.0%) in 1996-2008. Overall, the north experienced a fifth more premature (<75 years) deaths than the south, which was significant: a pattern that changed only by a slight increase between 1965 and 2008. Conclusion Inequalities in all cause mortality in the north-south divide were severe and persistent over the four decades from 1965 to 2008. Males were affected more than females, and the variation across age groups was substantial. The increase in this inequality from 2000 to 2008 was notable and occurred despite the public policy emphasis in England over this period on reducing inequalities in health. PMID:21325004

Trends in mortality from 1965 to 2008 across the English north-south divide: comparative observational study.

PubMed

Hacking, John M; Muller, Sara; Buchan, Iain E

2011-02-15

To compare all cause mortality between the north and south of England over four decades. Population wide comparative observational study of mortality. Five northernmost and four southernmost English government office regions. All residents in each year from 1965 to 2008. Death rate ratios of north over south England by age band and sex, and northern excess mortality (percentage of excess deaths in north compared with south, adjusted for age and sex and examined for annual trends, using Poisson regression). During 1965 to 2008 the northern excess mortality remained substantial, at an average of 13.8% (95% confidence interval 13.7% to 13.9%). This geographical inequality was significantly larger for males than for females (14.9%, 14.7% to 15.0% v 12.7%, 12.6% to 12.9%, P<0.001). The inequality decreased significantly but temporarily for both sexes from the early 80s to the late 90s, followed by a steep significant increase from 2000 to 2008. Inequality varied with age, being higher for ages 0-9 years and 40-74 years and lower for ages 10-39 years and over 75 years. Time trends also varied with age. The strongest trend over time by age group was the increase among the 20-34 age group, from no significant northern excess mortality in 1965-95 to 22.2% (18.7% to 26.0%) in 1996-2008. Overall, the north experienced a fifth more premature (<75 years) deaths than the south, which was significant: a pattern that changed only by a slight increase between 1965 and 2008. Inequalities in all cause mortality in the north-south divide were severe and persistent over the four decades from 1965 to 2008. Males were affected more than females, and the variation across age groups was substantial. The increase in this inequality from 2000 to 2008 was notable and occurred despite the public policy emphasis in England over this period on reducing inequalities in health.

A comparative study of sensor fault diagnosis methods based on observer for ECAS system

NASA Astrophysics Data System (ADS)

Xu, Xing; Wang, Wei; Zou, Nannan; Chen, Long; Cui, Xiaoli

2017-03-01

The performance and practicality of electronically controlled air suspension (ECAS) system are highly dependent on the state information supplied by kinds of sensors, but faults of sensors occur frequently. Based on a non-linearized 3-DOF 1/4 vehicle model, different methods of fault detection and isolation (FDI) are used to diagnose the sensor faults for ECAS system. The considered approaches include an extended Kalman filter (EKF) with concise algorithm, a strong tracking filter (STF) with robust tracking ability, and the cubature Kalman filter (CKF) with numerical precision. We propose three filters of EKF, STF, and CKF to design a state observer of ECAS system under typical sensor faults and noise. Results show that three approaches can successfully detect and isolate faults respectively despite of the existence of environmental noise, FDI time delay and fault sensitivity of different algorithms are different, meanwhile, compared with EKF and STF, CKF method has best performing FDI of sensor faults for ECAS system.

Are periprosthetic tissue reactions observed after revision of total disc replacement comparable to the reactions observed after total hip or knee revision surgery?

PubMed Central

Punt, Ilona M.; Austen, Shennah; Cleutjens, Jack P.M.; Kurtz, Steven M.; ten Broeke, René H.M.; van Rhijn, Lodewijk W.; Willems, Paul C.; van Ooij, André

2011-01-01

Study design Comparative study. Objective To compare periprosthetic tissue reactions observed after total disc replacement (TDR), total hip arthroplasty (THA) and total knee arthroplasty (TKA) revision surgery. Summary of background data Prosthetic wear debris leading to particle disease, followed by osteolysis, is often observed after THA and TKA. Although the presence of polyethylene (PE) particles and periprosthetic inflammation after TDR has been proven recently, osteolysis is rarely observed. The clinical relevance of PE wear debris in the spine remains poorly understood. Methods Number, size and shape of PE particles, as well as quantity and type of inflammatory cells in periprosthetic tissue retrieved during Charité TDR (n=22), THA (n=10) and TKA (n=4) revision surgery were compared. Tissue samples were stained with hematoxylin/eosin and examined by using light microscopy with bright field and polarized light. Results After THA, large numbers of PE particles <6 µm were observed, which were mainly phagocytosed by macrophages. The TKA group had a broad size range with many larger PE particles and more giant cells. In TDR, the size range was similar to that observed in TKA. However, the smallest particles were the most prevalent with 75% of the particles being <6 µm, as seen in revision THA. In TDR, both macrophages and giant cells were present with a higher number of macrophages. Conclusions Both small and large PE particles are present after TDR revision surgery compatible with both THA and TKA wear patterns. The similarities between periprosthetic tissue reactions in the different groups may give more insight in the clinical relevance of PE particles and inflammatory cells in the lumbar spine. The current findings may help to improve TDR design as applied from technologies previously developed in THA and TKA with the goal of a longer survival of TDR. PMID:21336235

HUMeral shaft fractures: measuring recovery after operative versus non-operative treatment (HUMMER): a multicenter comparative observational study.

PubMed

Mahabier, Kiran C; Van Lieshout, Esther M M; Bolhuis, Hugo W; Bos, P Koen; Bronkhorst, Maarten Wga; Bruijninckx, Milko M M; De Haan, Jeroen; Deenik, Axel R; Dwars, Boudewijn J; Eversdijk, Martin G; Goslings, J Carel; Haverlag, Robert; Heetveld, Martin J; Kerver, Albert J H; Kolkman, Karel A; Leenhouts, Peter A; Meylaerts, Sven A G; Onstenk, Ron; Poeze, Martijn; Poolman, Rudolf W; Punt, Bas J; Roerdink, W Herbert; Roukema, Gert R; Sintenie, Jan Bernard; Soesman, Nicolaj M R; Tanka, Andras K F; Ten Holder, Edgar J T; Van der Elst, Maarten; Van der Heijden, Frank H W M; Van der Linden, Frits M; Van der Zwaal, Peer; Van Dijk, Jan P; Van Jonbergen, Hans-Peter W; Verleisdonk, Egbert J M M; Vroemen, Jos P A M; Waleboer, Marco; Wittich, Philippe; Zuidema, Wietse P; Polinder, Suzanne; Verhofstad, Michael H J; Den Hartog, Dennis

2014-02-11

Fractures of the humeral shaft are associated with a profound temporary (and in the elderly sometimes even permanent) impairment of independence and quality of life. These fractures can be treated operatively or non-operatively, but the optimal tailored treatment is an unresolved problem. As no high-quality comparative randomized or observational studies are available, a recent Cochrane review concluded there is no evidence of sufficient scientific quality available to inform the decision to operate or not. Since randomized controlled trials for this injury have shown feasibility issues, this study is designed to provide the best achievable evidence to answer this unresolved problem. The primary aim of this study is to evaluate functional recovery after operative versus non-operative treatment in adult patients who sustained a humeral shaft fracture. Secondary aims include the effect of treatment on pain, complications, generic health-related quality of life, time to resumption of activities of daily living and work, and cost-effectiveness. The main hypothesis is that operative treatment will result in faster recovery. The design of the study will be a multicenter prospective observational study of 400 patients who have sustained a humeral shaft fracture, AO type 12A or 12B. Treatment decision (i.e., operative or non-operative) will be left to the discretion of the treating surgeon. Critical elements of treatment will be registered and outcome will be monitored at regular intervals over the subsequent 12 months. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand score. Secondary outcome measures are the Constant score, pain level at both sides, range of motion of the elbow and shoulder joint at both sides, radiographic healing, rate of complications and (secondary) interventions, health-related quality of life (Short-Form 36 and EuroQol-5D), time to resumption of ADL/work, and cost-effectiveness. Data will be analyzed using univariate

Comparing soil moisture memory in satellite observations and models

NASA Astrophysics Data System (ADS)

Stacke, Tobias; Hagemann, Stefan; Loew, Alexander

2013-04-01

A major obstacle to a correct parametrization of soil processes in large scale global land surface models is the lack of long term soil moisture observations for large parts of the globe. Currently, a compilation of soil moisture data derived from a range of satellites is released by the ESA Climate Change Initiative (ECV_SM). Comprising the period from 1978 until 2010, it provides the opportunity to compute climatological relevant statistics on a quasi-global scale and to compare these to the output of climate models. Our study is focused on the investigation of soil moisture memory in satellite observations and models. As a proxy for memory we compute the autocorrelation length (ACL) of the available satellite data and the uppermost soil layer of the models. Additional to the ECV_SM data, AMSR-E soil moisture is used as observational estimate. Simulated soil moisture fields are taken from ERA-Interim reanalysis and generated with the land surface model JSBACH, which was driven with quasi-observational meteorological forcing data. The satellite data show ACLs between one week and one month for the greater part of the land surface while the models simulate a longer memory of up to two months. Some pattern are similar in models and observations, e.g. a longer memory in the Sahel Zone and the Arabian Peninsula, but the models are not able to reproduce regions with a very short ACL of just a few days. If the long term seasonality is subtracted from the data the memory is strongly shortened, indicating the importance of seasonal variations for the memory in most regions. Furthermore, we analyze the change of soil moisture memory in the different soil layers of the models to investigate to which extent the surface soil moisture includes information about the whole soil column. A first analysis reveals that the ACL is increasing for deeper layers. However, its increase is stronger in the soil moisture anomaly than in its absolute values and the first even exceeds the

The value of including observational studies in systematic reviews was unclear: a descriptive study.

PubMed

Seida, Jennifer; Dryden, Donna M; Hartling, Lisa

2014-12-01

To evaluate (1) how often observational studies are included in comparative effectiveness reviews (CERs); (2) the rationale for including observational studies; (3) how data from observational studies are appraised, analyzed, and graded; and (4) the impact of observational studies on strength of evidence (SOE) and conclusions. Descriptive study of 23 CERs published through the Effective Health Care Program of the U.S. Agency for Healthcare Research and Quality. Authors searched for observational studies in 20 CERs, of which 18 included a median of 11 (interquartile range, 2-31) studies. Sixteen CERs incorporated the observational studies in their SOE assessments. Seventy-eight comparisons from 12 CERs included evidence from both trials and observational studies; observational studies had an impact on SOE and conclusions for 19 (24%) comparisons. There was diversity across the CERs regarding decisions to include observational studies; study designs considered; and approaches used to appraise, synthesize, and grade SOE. Reporting and methods guidance are needed to ensure clarity and consistency in how observational studies are incorporated in CERs. It was not always clear that observational studies added value in light of the additional resources needed to search for, select, appraise, and analyze such studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of case management in community aged care on client and carer outcomes: a systematic review of randomized trials and comparative observational studies

PubMed Central

2012-01-01

Background Case management has been applied in community aged care to meet frail older people’s holistic needs and promote cost-effectiveness. This systematic review aims to evaluate the effects of case management in community aged care on client and carer outcomes. Methods We searched Web of Science, Scopus, Medline, CINAHL (EBSCO) and PsycINFO (CSA) from inception to 2011 July. Inclusion criteria were: no restriction on date, English language, community-dwelling older people and/or carers, case management in community aged care, published in refereed journals, randomized control trials (RCTs) or comparative observational studies, examining client or carer outcomes. Quality of studies was assessed by using such indicators as quality control, randomization, comparability, follow-up rate, dropout, blinding assessors, and intention-to-treat analysis. Two reviewers independently screened potentially relevant studies, extracted information and assessed study quality. A narrative summary of findings were presented. Results Ten RCTs and five comparative observational studies were identified. One RCT was rated high quality. Client outcomes included mortality (7 studies), physical or cognitive functioning (6 studies), medical conditions (2 studies), behavioral problems (2 studies) , unmet service needs (3 studies), psychological health or well-being (7 studies) , and satisfaction with care (4 studies), while carer outcomes included stress or burden (6 studies), satisfaction with care (2 studies), psychological health or well-being (5 studies), and social consequences (such as social support and relationships with clients) (2 studies). Five of the seven studies reported that case management in community aged care interventions significantly improved psychological health or well-being in the intervention group, while all the three studies consistently reported fewer unmet service needs among the intervention participants. In contrast, available studies reported mixed

Quantifying the Hawthorne Effect in Hand Hygiene Compliance Through Comparing Direct Observation With Automated Hand Hygiene Monitoring.

PubMed

Hagel, Stefan; Reischke, Jana; Kesselmeier, Miriam; Winning, Johannes; Gastmeier, Petra; Brunkhorst, Frank M; Scherag, André; Pletz, Mathias W

2015-08-01

To quantify the Hawthorne effect of hand hygiene performance among healthcare workers using direct observation. Prospective observational study. Intensive care unit, university hospital. Direct observation of hand hygiene compliance over 48 audits of 2 hours each. Simultaneously, hand hygiene events (HHEs) were recorded using electronic alcohol-based handrub dispensers. Directly observed and electronically recorded HHEs during the 2 hours of direct observation were compared using Spearman correlations and Bland-Altman plots. To quantify the Hawthorne effect, we compared the number of electronically recorded HHEs during the direct observation periods with the re-scaled electronically recorded HHEs in the 6 remaining hours of the 8-hour working shift. A total of 3,978 opportunities for hand hygiene were observed during the 96 hours of direct observation. Hand hygiene compliance was 51% (95% CI, 49%-53%). There was a strong positive correlation between directly observed compliance and electronically recorded HHEs (ρ=0.68 [95% CI, 0.49-0.81], P<.0001). In the 384 hours under surveillance, 4,180 HHEs were recorded by the electronic dispensers. Of those, 2,029 HHEs were recorded during the 96 hours in which direct observation was also performed, and 2,151 HHEs were performed in the remaining 288 hours of the same working shift that were not under direct observation. Healthcare workers performed 8 HHEs per hour when not under observation compared with 21 HHEs per hour during observation. Directly and electronically observed HHEs were in agreement. We observed a marked influence of the Hawthorne effect on hand hygiene performance.

Comparing simulated and observed EMIC wave amplitudes using in situ Van Allen Probes’ measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saikin, A. A.; Jordanova, Vania Koleva; Zhang, J. C.

In this study, we perform a statistical study calculating electromagnetic ion cyclotron (EMIC) wave amplitudes based off in situ plasma measurements taken by the Van Allen Probes’ (1.1–5.8 R e) Helium, Oxygen, Proton, Electron (HOPE) instrument. Calculated wave amplitudes are compared to EMIC waves observed by the Electric and Magnetic Field Instrument Suite and Integrated Science on board the Van Allen Probes during the same period. The survey covers a 22-month period (1 November 2012 to 31 August 2014), a full Van Allen Probe magnetic local time (MLT) precession. The linear theory proxy was used to identify EMIC wave eventsmore » with plasma conditions favorable for EMIC wave excitation. Two hundred and thirty-two EMIC wave events (103 H +-band and 129 He +-band) were selected for this comparison. Nearly all events selected are observed beyond L = 4. Results show that calculated wave amplitudes exclusively using the in situ HOPE measurements produce amplitudes too low compared to the observed EMIC wave amplitudes. Hot proton anisotropy (Ahp) distributions are asymmetric in MLT within the inner (L < 7) magnetosphere with peak (minimum) A hp, ~0.81 to 1.00 (~0.62), observed in the dawn (dusk), 0000 < MLT ≤ 1200 (1200 < MLT ≤ 2400), sectors. Measurements of A hp are found to decrease in the presence of EMIC wave activity. A hp amplification factors are determined and vary with respect to EMIC wave-band and MLT. Lastly, He +-band events generally require double (quadruple) the measured A hp for the dawn (dusk) sector to reproduce the observed EMIC wave amplitudes.« less

Comparing simulated and observed EMIC wave amplitudes using in situ Van Allen Probes’ measurements

DOE PAGES

Saikin, A. A.; Jordanova, Vania Koleva; Zhang, J. C.; ...

2018-02-02

In this study, we perform a statistical study calculating electromagnetic ion cyclotron (EMIC) wave amplitudes based off in situ plasma measurements taken by the Van Allen Probes’ (1.1–5.8 R e) Helium, Oxygen, Proton, Electron (HOPE) instrument. Calculated wave amplitudes are compared to EMIC waves observed by the Electric and Magnetic Field Instrument Suite and Integrated Science on board the Van Allen Probes during the same period. The survey covers a 22-month period (1 November 2012 to 31 August 2014), a full Van Allen Probe magnetic local time (MLT) precession. The linear theory proxy was used to identify EMIC wave eventsmore » with plasma conditions favorable for EMIC wave excitation. Two hundred and thirty-two EMIC wave events (103 H +-band and 129 He +-band) were selected for this comparison. Nearly all events selected are observed beyond L = 4. Results show that calculated wave amplitudes exclusively using the in situ HOPE measurements produce amplitudes too low compared to the observed EMIC wave amplitudes. Hot proton anisotropy (Ahp) distributions are asymmetric in MLT within the inner (L < 7) magnetosphere with peak (minimum) A hp, ~0.81 to 1.00 (~0.62), observed in the dawn (dusk), 0000 < MLT ≤ 1200 (1200 < MLT ≤ 2400), sectors. Measurements of A hp are found to decrease in the presence of EMIC wave activity. A hp amplification factors are determined and vary with respect to EMIC wave-band and MLT. Lastly, He +-band events generally require double (quadruple) the measured A hp for the dawn (dusk) sector to reproduce the observed EMIC wave amplitudes.« less

Observational Studies: Cohort and Case-Control Studies

PubMed Central

Song, Jae W.; Chung, Kevin C.

2010-01-01

Observational studies are an important category of study designs. To address some investigative questions in plastic surgery, randomized controlled trials are not always indicated or ethical to conduct. Instead, observational studies may be the next best method to address these types of questions. Well-designed observational studies have been shown to provide results similar to randomized controlled trials, challenging the belief that observational studies are second-rate. Cohort studies and case-control studies are two primary types of observational studies that aid in evaluating associations between diseases and exposures. In this review article, we describe these study designs, methodological issues, and provide examples from the plastic surgery literature. PMID:20697313

How do outcomes compare between women and men living with HIV in Australia? An observational study.

PubMed

Giles, Michelle L; Zapata, Marin C; Wright, Stephen T; Petoumenos, Kathy; Grotowski, Miriam; Broom, Jennifer; Law, Matthew G; O'Connor, Catherine C

2016-04-01

Background Gender differences vary across geographical settings and are poorly reported in the literature. The aim of this study was to evaluate demographics and clinical characteristics of participants from the Australian HIV Observational Database (AHOD), and to explore any differences between females and males in the rate of new clinical outcomes, as well as initial immunological and virological response to antiretroviral therapy. Time to a new clinical end-point, all-cause mortality and/or AIDS illness was analysed using standard survival methods. Univariate and covariate adjusted Cox proportional hazard models were used to evaluate the time to plasma viral load suppression in all patients that initiated antiretroviral therapy (ART) and time to switching from a first-line ART to a second-line ART regimen. There was no significant difference between females and males for the hazard of all-cause mortality [adjusted hazard ratio: 0.98 (0.51, 1.55), P=0.67], new AIDS illness [adjusted hazard ratio: 0.75 (0.38, 1.48), P=0.41] or a composite end-point [adjusted hazard ratio: 0.74 (0.45, 1.21), P=0.23]. Incident rates of all-cause mortality were similar between females and males; 1.14 (0.61, 1.95) vs 1.28 (1.12, 1.45) per 100 person years. Virological response to ART was similar for females and males when measured as time to viral suppression and/or time to virological failure. This study supports current Australian HIV clinical care as providing equivalent standards of care for male and female HIV-positive patients. Future studies should compare ART-associated toxicity differences between ART-associated toxicity differences between men and women living with HIV in Australia.

Accuracy of physician self-assessment compared with observed measures of competence: a systematic review.

PubMed

Davis, David A; Mazmanian, Paul E; Fordis, Michael; Van Harrison, R; Thorpe, Kevin E; Perrier, Laure

2006-09-06

Core physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs. To determine how accurately physicians self-assess compared with external observations of their competence. The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection. Studies were included if they compared physicians' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention. Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted. The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and

Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice

PubMed Central

van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

2016-01-01

Objective Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. Setting The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Primary and secondary outcome measures Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Results Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Conclusions Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated

Regional Geoid Modeling Compared to Ocean Surface Observations

NASA Astrophysics Data System (ADS)

Roman, D. R.; Saleh, J.; Wang, Y. M.

2007-05-01

Aerogravity over a limited coastal region of the northern Gulf of Mexico enhanced and rectified the local gravity field signal. In turn, these data improved the derived geoid height model based on comparison with dynamic ocean topography (DOT) and tide gage information at eleven stations. Additionally, lidar observations were analyzed along nearly 50 profiles to estimate the reliability of these models into the offshore region. The overall comparison shows dm-level agreement between the various geoid and DOT models and ocean surface observations. An approximate 30 cm bias must still be explained; however, the results of this study point to the potential for further cooperative studies between oceanographers and geodesists.

Comparative Study of Intramedullary Hammertoe Fixation.

PubMed

Obrador, Caterina; Losa-Iglesias, Marta; Becerro-de-Bengoa-Vallejo, Ricardo; Kabbash, Christina A

2018-04-01

Temporary Kirschner wire fixation (K-wire) is a widely used, low-cost fixation method for the correction of hammertoe deformity. Reported complications associated with K-wires prompted the development of new implants over the past decade. However, there is a lack of literature on comparative studies analyzing functional outcomes using validated questionnaires. The purpose of this study was to analyze functional outcomes in patients who had undergone proximal interphalangeal joint fusion using 2 types of intramedullary implant, the Smart Toe and the TenFuse, and to compare them with the outcomes in patients treated with standard K-wire fixation. A retrospective review of operative hammertoe correction by a single surgeon was performed in 96 patients followed for more than 12 months. Functional outcome was assessed using the Foot Function Index (FFI), the Short Form 36 (SF-36), and the 10-point visual analog scale (VAS) validated questionnaires. Complications and fusion rates were also evaluated. Several patients in the study underwent corrections in different toes; thus, a total of 186 toes were included in the study. From these, 65 toes (34.9%) were treated with K-wire fixation, 94 (50.5%) with Smart Toe titanium implant, and 27 (14.5%) with TenFuse allograft implant. No statistically significant differences in functional outcome and incidence of complications were observed among the 3 fixation groups, although the 2 intramedullary implants were associated with greater fusion rates and patient satisfaction. Breakage of the Smart Toe implant was significantly higher than that of the other fixations, with 10.6% of implants breaking within the first year postoperatively. SF-36 and VAS scores decreased 12 months after surgery for the 3 types of fixation, with no statistically significant differences observed. The use of Smart Toe and TenFuse implants provided operative outcomes comparable to those obtained using a K-wire fixation and slightly better patient

White-Light Observations of Major Flares Compared to Total Solar Irradiance and Short-Wavelength Observations

NASA Astrophysics Data System (ADS)

Petrie, Gordon; Kopp, Greg; Harvey, J. W.

2014-06-01

The NSO’s GONG network produces “white light” (WL) continuum intensity images from one-minute integrations averaged across a 0. Å wide band pass centered at 676 Å at one minute cadence using six sites worldwide. Clear WL signatures of solar flares are present in GONG intensity data for only the largest flares because of low spatial resolution (2.5 arcsec pixel size). For six major flares (GOES class X6.5 - X28) observed by GONG, we compare integrated GONG full-disk WL intensity curves with SORCE/TIM total solar irradiance (TSI) measurements. Distinctive p-mode signatures are evident in both GONG and SORCE time series, though the correlation between GONG and SORCE data varies from flare to flare. In some cases a clear TSI peak and an interruption of the GONG p-mode pattern accompany the flare. The flare signature is generally weaker in the GONG data, suggesting that most of the TIM flare signal arises from wavelengths shorter than the GONG band pass. The flare kernels nevertheless are clear and last many minutes in the spatially resolved GONG image time series. We also compare the GONG active region intensity observations with shorter-wavelength data. In one case observed by TRACE, the GONG and TRACE WL curves are very similar and the TRACE 160 Å curve shows a significant precursor and a long tail. In most cases the GONG WL and RHESSI 25-100 keV counts appear well correlated in time. This work utilizes GONG data obtained by the NSO Integrated Synoptic Program (NISP), managed by the National Solar Observatory, which is operated by AURA, Inc. under a cooperative agreement with the National Science Foundation.

Extra-Tropical Cyclones at Climate Scales: Comparing Models to Observations

NASA Astrophysics Data System (ADS)

Tselioudis, G.; Bauer, M.; Rossow, W.

2009-04-01

Climate is often defined as the accumulation of weather, and weather is not the concern of climate models. Justification for this latter sentiment has long been hidden behind coarse model resolutions and blunt validation tools based on climatological maps. The spatial-temporal resolutions of today's climate models and observations are converging onto meteorological scales, however, which means that with the correct tools we can test the largely unproven assumption that climate model weather is correct enough that its accumulation results in a robust climate simulation. Towards this effort we introduce a new tool for extracting detailed cyclone statistics from observations and climate model output. These include the usual cyclone characteristics (centers, tracks), but also adaptive cyclone-centric composites. We have created a novel dataset, the MAP Climatology of Mid-latitude Storminess (MCMS), which provides a detailed 6 hourly assessment of the areas under the influence of mid-latitude cyclones, using a search algorithm that delimits the boundaries of each system from the outer-most closed SLP contour. Using this we then extract composites of cloud, radiation, and precipitation properties from sources such as ISCCP and GPCP to create a large comparative dataset for climate model validation. A demonstration of the potential usefulness of these tools in process-based climate model evaluation studies will be shown.

How do outcomes compare between women and men living with HIV in Australia? An observational study

PubMed Central

Giles, Michelle L.; Zapata, Marin C.; Wright, Stephen T.; Petoumenos, Kathy; Grotowski, Miriam; Broom, Jennifer; Law, Matthew G.; O’Connor, Catherine C.

2018-01-01

Background Gender differences vary across geographical settings and are poorly reported in the literature. The aim of this study was to evaluate demographics and clinical characteristics of participants from the Australian HIV Observational Database (AHOD), and to explore any differences between females and males in the rate of new clinical outcomes, as well as initial immunological and virological response to antiretroviral therapy. Methods Time to a new clinical end-point, all-cause mortality and/or AIDS illness was analysed using standard survival methods. Univariate and covariate adjusted Cox proportional hazard models were used to evaluate the time to plasma viral load suppression in all patients that initiated antiretroviral therapy (ART) and time to switching from a first-line ART to a second-line ART regimen. Results There was no significant difference between females and males for the hazard of all-cause mortality [adjusted hazard ratio: 0.98 (0.51, 1.55), P = 0.67], new AIDS illness [adjusted hazard ratio: 0.75 (0.38, 1.48), P = 0.41] or a composite end-point [adjusted hazard ratio: 0.74 (0.45, 1.21), P = 0.23]. Incident rates of all-cause mortality were similar between females and males; 1.14 (0.61, 1.95) vs 1.28 (1.12, 1.45) per 100 person years. Virological response to ART was similar for females and males when measured as time to viral suppression and/or time to virological failure. Conclusion This study supports current Australian HIV clinical care as providing equivalent standards of care for male and female HIV-positive patients. Future studies should compare ART-associated toxicity differences between ART-associated toxicity differences between men and women living with HIV in Australia. PMID:26827052

Comparative ELM study between the observation by ECEI and linear/nonlinear simulation in the KSTAR plasmas

NASA Astrophysics Data System (ADS)

Kim, Minwoo; Park, Hyeon K.; Yun, Gunsu; Lee, Jaehyun; Lee, Jieun; Lee, Woochang; Jardin, Stephen; Xu, X. Q.; Kstar Team

2015-11-01

The modeling of the Edge-localized-mode (ELM) should be rigorously pursued for reliable and robust ELM control for steady-state long-pulse H-mode operation in ITER as well as DEMO. In the KSTAR discharge #7328, a linear stability of the ELMs is investigated using M3D-C1 and BOUT + + codes. This is achieved by linear simulation for the n = 8 mode structure of the ELM observed by the KSTAR electron cyclotron emission imaging (ECEI) systems. In the process of analysis, variations due to the plasma equilibrium profiles and transport coefficients on the ELM growth rate are investigated and simulation results with the two codes are compared. The numerical simulations are extended to nonlinear phase of the ELM dynamics, which includes saturation and crash of the modes. Preliminary results of the nonlinear simulations are compared with the measured images especially from the saturation to the crash. This work is supported by NRF of Korea under contract no. NRF-2014M1A7A1A03029865, US DoE by LLNL under contract DE-AC52-07NA27344 and US DoE by PPPL under contract DE-AC02-09CH11466.

An 'Observational Large Ensemble' to compare observed and modeled temperature trend uncertainty due to internal variability.

NASA Astrophysics Data System (ADS)

Poppick, A. N.; McKinnon, K. A.; Dunn-Sigouin, E.; Deser, C.

2017-12-01

Initial condition climate model ensembles suggest that regional temperature trends can be highly variable on decadal timescales due to characteristics of internal climate variability. Accounting for trend uncertainty due to internal variability is therefore necessary to contextualize recent observed temperature changes. However, while the variability of trends in a climate model ensemble can be evaluated directly (as the spread across ensemble members), internal variability simulated by a climate model may be inconsistent with observations. Observation-based methods for assessing the role of internal variability on trend uncertainty are therefore required. Here, we use a statistical resampling approach to assess trend uncertainty due to internal variability in historical 50-year (1966-2015) winter near-surface air temperature trends over North America. We compare this estimate of trend uncertainty to simulated trend variability in the NCAR CESM1 Large Ensemble (LENS), finding that uncertainty in wintertime temperature trends over North America due to internal variability is largely overestimated by CESM1, on average by a factor of 32%. Our observation-based resampling approach is combined with the forced signal from LENS to produce an 'Observational Large Ensemble' (OLENS). The members of OLENS indicate a range of spatially coherent fields of temperature trends resulting from different sequences of internal variability consistent with observations. The smaller trend variability in OLENS suggests that uncertainty in the historical climate change signal in observations due to internal variability is less than suggested by LENS.

Direct comparative effectiveness and safety between non-vitamin K antagonist oral anticoagulants for stroke prevention in nonvalvular atrial fibrillation: a systematic review and meta-analysis of observational studies.

PubMed

Li, Guowei; Lip, Gregory Y H; Holbrook, Anne; Chang, Yaping; Larsen, Torben B; Sun, Xin; Tang, Jie; Mbuagbaw, Lawrence; Witt, Daniel M; Crowther, Mark; Thabane, Lehana; Levine, Mitchell A H

2018-06-08

The non-vitamin K antagonist oral anticoagulants (NOACs) have been increasingly prescribed in clinical practice for stroke prevention in patients with nonvalvular atrial fibrillation (AF). Direct comparisons between NOACs in trials are lacking, leaving an important clinical decision-making gap. We aimed to perform a systematic review and meta-analysis to summarize the evidence of observational studies for direct comparative effectiveness and safety amongst NOACs in patients with AF. Conference proceedings and electronic databases including MEDLINE, CINAHL, EMBASE and PUBMED were systematically searched. We included observational studies directly comparing individual NOACs in patients with nonvalvular AF who were aged ≥ 18 years for stroke prevention. Primary outcome included effectiveness outcome (stroke or systemic embolism) and safety outcome (major bleeding). Data were extracted in duplicated by two reviewers independently. A random-effects meta-analysis was conducted to synthesize the data from included observational studies. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to rate the overall quality of evidence for each outcome. Fifteen studies were included for qualitative synthesis, twelve studies for meta-analyses. It was found that rivaroxaban and dabigatran were similar with regard to risk of stroke or systemic embolism (Hazard ratio [HR] = 1.00, 95% CI 0.91-1.10; evidence quality: low), but rivaroxaban was associated with higher risk of major bleeding (HR = 1.39, 95% CI 1.28-1.50; evidence quality: moderate). Compared with apixaban, a significantly higher risk of major bleeding was observed with rivaroxaban (HR = 1.71, 95% CI 1.51-1.94; evidence quality: low). Apixaban was associated with lower risk of major bleeding, in comparison with dabigatran (HR = 0.80, 95% CI 0.68-0.95; evidence quality: low). No differences in risk of stroke or systemic embolism was observed between rivaroxaban versus

Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice.

PubMed

van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

2016-08-08

Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated urinalysis in general practice is justified as automation is expected to reduce

Satellite microwave observations of a storm complex: A comparative analysis

NASA Technical Reports Server (NTRS)

Martin, D. W.

1985-01-01

The hypothesis that cold events correspond to a particular stage in a class of thunderstorms was tested. That class is a storms class which updrafts are: (1) strong, broad and moist, and (2) extend well above the freezing level. Condition (1) implies strong mesoscale forcing. Condition (2) implies a tall updraft or a relatively low freezing level. Such storms should have big, intense radar echoes and cold, fast-growing anvils. The thunderstorm events were analyzed by radar, rain gauge and GOES infrared observations. Radar was the starting point for detection and definition of the hypothesized thunderstorms. The radar signature is compared to the signature of the storm in rain gauge observations, satellite infrared images and satellite microwave images.

Detectability index of differential phase contrast CT compared with conventional CT: a preliminary channelized Hotelling observer study

NASA Astrophysics Data System (ADS)

Tang, Xiangyang; Yang, Yi; Tang, Shaojie

2013-03-01

Under the framework of model observer with signal and background exactly known (SKE/BKE), we investigate the detectability of differential phase contrast CT compared with that of the conventional attenuation-based CT. Using the channelized Hotelling observer and the radially symmetric difference-of-Gaussians channel template , we investigate the detectability index and its variation over the dimension of object and detector cells. The preliminary data show that the differential phase contrast CT outperforms the conventional attenuation-based CT significantly in the detectability index while both the object to be detected and the cell of detector used for data acquisition are relatively small. However, the differential phase contrast CT's dominance in the detectability index diminishes with increasing dimension of either object or detector cell, and virtually disappears while the dimension of object or detector cell approaches a threshold, respectively. It is hoped that the preliminary data reported in this paper may provide insightful understanding of the differential phase contrast CT's characteristic in the detectability index and its comparison with that of the conventional attenuation-based CT.

Roles of Naturalistic Observation in Comparative Psychology

ERIC Educational Resources Information Center

Miller, David B.

1977-01-01

"Five roles are considered by which systematic, quantified field research can augment controlled laboratory experimentation in terms of increasing the validity of laboratory studies." Advocates that comparative psychologists should "take more initiative in designing, executing, and interpreting our experiments with regard to the natural history of…

Cervical Proprioception in a Young Population Who Spend Long Periods on Mobile Devices: A 2-Group Comparative Observational Study.

PubMed

Portelli, Andrew; Reid, Susan A

2018-02-01

The purpose of this study was to evaluate if young people with insidious-onset neck pain who spend long periods on mobile electronic devices (known as "text neck") have impaired cervical proprioception and if this is related to time on devices. A 2-group comparative observational study was conducted at an Australian university. Twenty-two participants with text neck and 22 asymptomatic controls, all of whom were 18 to 35 years old and spent ≥4 hours per day on unsupported electronic devices, were assessed using the head repositioning accuracy (HRA) test. Differences between groups were calculated using independent sample t-tests, and correlations between neck pain intensity, time on devices, and HRA test were performed using Pearson's bivariate analysis. During cervical flexion, those with text neck (n = 22, mean age ± standard deviation [SD]: 21 ± 4 years, 59% female) had a 3.9° (SD: 1.4°) repositioning error, and the control group (n = 22, 20 ± 1 years, 68% female) had a 2.9° (SD: 1.2°) error. The mean difference was 1° (95% confidence interval: 0-2, P = .02). For other cervical movements, there was no difference between groups. There was a moderately significant correlation (P ≤ .05) between time spent on electronic devices and cervical pain intensity and between cervical pain intensity and HRA during flexion. The participants with text neck had a greater proprioceptive error during cervical flexion compared with controls. This could be related to neck pain and time spent on electronic devices. Copyright © 2018. Published by Elsevier Inc.

BinMag: Widget for comparing stellar observed with theoretical spectra

NASA Astrophysics Data System (ADS)

Kochukhov, O.

2018-05-01

BinMag examines theoretical stellar spectra computed with Synth/SynthMag/Synmast/Synth3/SME spectrum synthesis codes and compare them to observations. An IDL widget program, BinMag applies radial velocity shift and broadening to the theoretical spectra to account for the effects of stellar rotation, radial-tangential macroturbulence, instrumental smearing. The code can also simulate spectra of spectroscopic binary stars by appropriate coaddition of two synthetic spectra. Additionally, BinMag can be used to measure equivalent width, fit line profile shapes with analytical functions, and to automatically determine radial velocity and broadening parameters. BinMag interfaces with the Synth3 (ascl:1212.010) and SME (ascl:1202.013) codes, allowing the user to determine chemical abundances and stellar atmospheric parameters from the observed spectra.

The dynamics of human-water systems: comparing observations and simulations

NASA Astrophysics Data System (ADS)

Di Baldassarre, G.; Ciullo, A.; Castellarin, A.; Viglione, A.

2016-12-01

Real-word data of human-flood interactions are compared to the results of stylized socio-hydrological models. These models build on numerous examples from different parts of the world and consider two main prototypes of floodplain systems. Green systems, whereby societies cope with flood risk via non-structural measures, e.g. resettling out of floodplain areas ("living with floods" approach); and Technological systems, whereby societies cope with flood risk by also via structural measures, e.g. building levees ("fighting floods" approach). The floodplain systems of the Tiber River in Rome and the Ganges-Brahmaputra-Meghna Rivers in Bangladesh systems are used as case studies. The comparison of simulations and observations shows the potential of socio-hydrological models in capturing the dynamics of risk emerging from the interactions and feedbacks between social and hydrological processes, such as learning and forgetting effects. It is then discussed how the proposed approach can contribute to a better understanding of flood risk changes and therefore support the process of disaster risk reduction.

Do heads of government age more quickly? Observational study comparing mortality between elected leaders and runners-up in national elections of 17 countries

PubMed Central

Olenski, Andrew R; Abola, Matthew V

2015-01-01

Objectives To determine whether being elected to head of government is associated with accelerated mortality by studying survival differences between people elected to office and unelected runner-up candidates who never served. Design Observational study. Setting Historical survival data on elected and runner-up candidates in parliamentary or presidential elections in Australia, Austria, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, New Zealand, Norway, Poland, Spain, Sweden, United Kingdom, and United States, from 1722 to 2015. Participants Elected and runner-up political candidates. Main outcome measure Observed number of years alive after each candidate’s last election, relative to what would be expected for an average person of the same age and sex as the candidate during the year of the election, based on historical French and British life tables. Observed post-election life years were compared between elected candidates and runners-up, adjusting for life expectancy at time of election. A Cox proportional hazards model (adjusted for candidate’s life expectancy at the time of election) considered years until death (or years until end of study period for those not yet deceased by 9 September 2015) for elected candidates versus runners-up. Results The sample included 540 candidates: 279 winners and 261 runners-up who never served. A total of 380 candidates were deceased by 9 September 2015. Candidates who served as a head of government lived 4.4 (95% confidence interval 2.1 to 6.6) fewer years after their last election than did candidates who never served (17.8 v 13.4 years after last election; adjusted difference 2.7 (0.6 to 4.8) years). In Cox proportional hazards analysis, which considered all candidates (alive or deceased), the mortality hazard for elected candidates relative to runners-up was 1.23 (1.00 to 1.52). Conclusions Election to head of government is associated with a substantial increase in mortality risk compared

Do heads of government age more quickly? Observational study comparing mortality between elected leaders and runners-up in national elections of 17 countries.

PubMed

Olenski, Andrew R; Abola, Matthew V; Jena, Anupam B

2015-12-14

To determine whether being elected to head of government is associated with accelerated mortality by studying survival differences between people elected to office and unelected runner-up candidates who never served. Observational study. Historical survival data on elected and runner-up candidates in parliamentary or presidential elections in Australia, Austria, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, New Zealand, Norway, Poland, Spain, Sweden, United Kingdom, and United States, from 1722 to 2015. Elected and runner-up political candidates. Observed number of years alive after each candidate's last election, relative to what would be expected for an average person of the same age and sex as the candidate during the year of the election, based on historical French and British life tables. Observed post-election life years were compared between elected candidates and runners-up, adjusting for life expectancy at time of election. A Cox proportional hazards model (adjusted for candidate's life expectancy at the time of election) considered years until death (or years until end of study period for those not yet deceased by 9 September 2015) for elected candidates versus runners-up. The sample included 540 candidates: 279 winners and 261 runners-up who never served. A total of 380 candidates were deceased by 9 September 2015. Candidates who served as a head of government lived 4.4 (95% confidence interval 2.1 to 6.6) fewer years after their last election than did candidates who never served (17.8 v 13.4 years after last election; adjusted difference 2.7 (0.6 to 4.8) years). In Cox proportional hazards analysis, which considered all candidates (alive or deceased), the mortality hazard for elected candidates relative to runners-up was 1.23 (1.00 to 1.52). Election to head of government is associated with a substantial increase in mortality risk compared with candidates in national elections who never served. Published by the BMJ Publishing Group

Safety and efficacy of hysteroscopic sterilization compared with laparoscopic sterilization: an observational cohort study.

PubMed

Mao, Jialin; Pfeifer, Samantha; Schlegel, Peter; Sedrakyan, Art

2015-10-13

To compare the safety and efficacy of hysteroscopic sterilization with the "Essure" device with laparoscopic sterilization in a large, all-inclusive, state cohort. Population based cohort study. Outpatient interventional setting in New York State. Women undergoing interval sterilization procedure, including hysteroscopic sterilization with Essure device and laparoscopic surgery, between 2005 and 2013. Safety events within 30 days of procedures; unintended pregnancies and reoperations within one year of procedures. Mixed model accounting for hospital clustering was used to compare 30 day and 1 year outcomes, adjusting for patient characteristics and other confounders. Time to reoperation was evaluated using frailty model for time to event analysis. We identified 8048 patients undergoing hysteroscopic sterilization and 44,278 undergoing laparoscopic sterilization between 2005 and 2013 in New York State. There was a significant increase in the use of hysteroscopic procedures during this period, while use of laparoscopic sterilization decreased. Patients undergoing hysteroscopic sterilization were older than those undergoing laparoscopic sterilization and were more likely to have a history of pelvic inflammatory disease (10.3% v 7.2%, P<0.01), major abdominal surgery (9.4% v 7.9%, P<0.01), and cesarean section (23.2% v 15.4%, P<0.01). At one year after surgery, hysteroscopic sterilization was not associated with a higher risk of unintended pregnancy (odds ratio 0.84 (95% CI 0.63 to 1.12)) but was associated with a substantially increased risk of reoperation (odds ratio 10.16 (7.47 to 13.81)) compared with laparoscopic sterilization. Patients undergoing hysteroscopic sterilization have a similar risk of unintended pregnancy but a more than 10-fold higher risk of undergoing reoperation compared with patients undergoing laparoscopic sterilization. Benefits and risks of both procedures should be discussed with patients for informed decisions making. © Mao et al 2015.

Safety and efficacy of hysteroscopic sterilization compared with laparoscopic sterilization: an observational cohort study

PubMed Central

Mao, Jialin; Pfeifer, Samantha; Schlegel, Peter

2015-01-01

Objective To compare the safety and efficacy of hysteroscopic sterilization with the “Essure” device with laparoscopic sterilization in a large, all-inclusive, state cohort. Design Population based cohort study. Settings Outpatient interventional setting in New York State. Participants Women undergoing interval sterilization procedure, including hysteroscopic sterilization with Essure device and laparoscopic surgery, between 2005 and 2013. Main outcomes measures Safety events within 30 days of procedures; unintended pregnancies and reoperations within one year of procedures. Mixed model accounting for hospital clustering was used to compare 30 day and 1 year outcomes, adjusting for patient characteristics and other confounders. Time to reoperation was evaluated using frailty model for time to event analysis. Results We identified 8048 patients undergoing hysteroscopic sterilization and 44 278 undergoing laparoscopic sterilization between 2005 and 2013 in New York State. There was a significant increase in the use of hysteroscopic procedures during this period, while use of laparoscopic sterilization decreased. Patients undergoing hysteroscopic sterilization were older than those undergoing laparoscopic sterilization and were more likely to have a history of pelvic inflammatory disease (10.3% v 7.2%, P<0.01), major abdominal surgery (9.4% v 7.9%, P<0.01), and cesarean section (23.2% v 15.4%, P<0.01). At one year after surgery, hysteroscopic sterilization was not associated with a higher risk of unintended pregnancy (odds ratio 0.84 (95% CI 0.63 to 1.12)) but was associated with a substantially increased risk of reoperation (odds ratio 10.16 (7.47 to 13.81)) compared with laparoscopic sterilization. Conclusions Patients undergoing hysteroscopic sterilization have a similar risk of unintended pregnancy but a more than 10-fold higher risk of undergoing reoperation compared with patients undergoing laparoscopic sterilization. Benefits and risks of both procedures

Halo Coronal Mass Ejections: Comparing Observations and Models

NASA Technical Reports Server (NTRS)

Gilbert, Holly; Orlove, Matthew; SaintCyr, O.; Mays, L.; Gopalswamy, N.

2011-01-01

Since 1996, the SOHO LASCO coronagraphs have detected "halo" CMEs that appear to be directed toward Earth, but information about the size and speed of these events seen face-on has been limited. From a single vantage point along the Sun-Earth line, the primary limitation has been ambiguity in fitting the cone model (or other forward-modeling techniques, e.g., Thernisian et al., 2006). But in the past few years, the STEREO mission has provided a view of Earth-directed events from the side. These events offer the opportunity to compare measurements (width and speed) of halo CMEs observed by STEREO with models that derive halo CME properties. We report here results of such a comparison on a large sample of LASCO CMEs in the STEREO era.

Comparing Simulations and Observations of Galaxy Evolution: Methods for Constraining the Nature of Stellar Feedback

NASA Astrophysics Data System (ADS)

Hummels, Cameron

Computational hydrodynamical simulations are a very useful tool for understanding how galaxies form and evolve over cosmological timescales not easily revealed through observations. However, they are only useful if they reproduce the sorts of galaxies that we see in the real universe. One of the ways in which simulations of this sort tend to fail is in the prescription of stellar feedback, the process by which nascent stars return material and energy to their immediate environments. Careful treatment of this interaction in subgrid models, so-called because they operate on scales below the resolution of the simulation, is crucial for the development of realistic galaxy models. Equally important is developing effective methods for comparing simulation data against observations to ensure galaxy models which mimic reality and inform us about natural phenomena. This thesis examines the formation and evolution of galaxies and the observable characteristics of the resulting systems. We employ extensive use of cosmological hydrodynamical simulations in order to simulate and interpret the evolution of massive spiral galaxies like our own Milky Way. First, we create a method for producing synthetic photometric images of grid-based hydrodynamical models for use in a direct comparison against observations in a variety of filter bands. We apply this method to a simulation of a cluster of galaxies to investigate the nature of the red-sequence/blue-cloud dichotomy in the galaxy color-magnitude diagram. Second, we implement several subgrid models governing the complex behavior of gas and stars on small scales in our galaxy models. Several numerical simulations are conducted with similar initial conditions, where we systematically vary the subgrid models, afterward assessing their efficacy through comparisons of their internal kinematics with observed systems. Third, we generate an additional method to compare observations with simulations, focusing on the tenuous circumgalactic

COMPARATIVE STUDY OF ASYMMETRY ORIGIN OF GALAXIES IN DIFFERENT ENVIRONMENTS. I. OPTICAL OBSERVATIONS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Plauchu-Frayn, I.; Coziol, R., E-mail: plauchuf@astro.ugto.m, E-mail: rcoziol@astro.ugto.m

2010-06-15

This paper presents the first of two analyses about the influence of environment on the formation and evolution of galaxies observed in the nearby universe. For our study, we used three different samples representing different density environments: galaxies in Compact Groups (HCGs), Isolated Pairs of Galaxies (KPGs), and Isolated Galaxies (KIGs), which were taken as references. Usingboth characteristic isophotal parameters and evidence of asymmetries in the optical and the near-infrared, we are able to establish differences in the characteristics of galaxies with different morphologies in different environments, allowing us to better understand their different formation histories. In this first paper,more » we present the isophotal and asymmetry analyses of a sample of 214 galaxies in different environments observed in the optical (V and I images). For each galaxy, we have determined different characteristic isophotal parameters and V - I color profiles, as a function of semi-major axis, and performed a full asymmetry analysis in residual images using the V filter. Evidence of asymmetry in the optical is almost missing in the KIG sample and significantly more common in the KPG than in the HCG samples. Our isophotal analysis suggests that the stellar populations in the HCG galaxies are older and more dynamically relaxed than in the KPG. The HCG galaxies seem to be at a more advanced stage of interaction than the KPGs. One possible explanation is that these structures formed at different epochs: compact groups of galaxies would have formed before close pairs of galaxies, which only began interacting recently. However, similarities in the formation process of galaxies with same morphology suggest CGs and close pairs of galaxies share similar conditions; they are new structures forming relatively late in low-density environments.« less

Helping Teenagers Stop Smoking: Comparative Observations across Youth Settings in Cardiff

ERIC Educational Resources Information Center

Bowles, Hannah; Maher, Alison; Sage, Robert

2009-01-01

Objective: This paper presents comparative observations between schools/colleges, youth centres, and specialist youth provision, in relation to delivery of the 2tuff2puff six-week smoking cessation and awareness programme to young people in Cardiff. Design: A six-week smoking cessation programme was delivered to 12-23 year olds in various youth…

Do observational studies using propensity score methods agree with randomized trials? A systematic comparison of studies on acute coronary syndromes

PubMed Central

Dahabreh, Issa J.; Sheldrick, Radley C.; Paulus, Jessica K.; Chung, Mei; Varvarigou, Vasileia; Jafri, Haseeb; Rassen, Jeremy A.; Trikalinos, Thomas A.; Kitsios, Georgios D.

2012-01-01

Aims Randomized controlled trials (RCTs) are the gold standard for assessing the efficacy of therapeutic interventions because randomization protects from biases inherent in observational studies. Propensity score (PS) methods, proposed as a potential solution to confounding of the treatment–outcome association, are widely used in observational studies of therapeutic interventions for acute coronary syndromes (ACS). We aimed to systematically assess agreement between observational studies using PS methods and RCTs on therapeutic interventions for ACS. Methods and results We searched for observational studies of interventions for ACS that used PS methods to estimate treatment effects on short- or long-term mortality. Using a standardized algorithm, we matched observational studies to RCTs based on patients’ characteristics, interventions, and outcomes (‘topics’), and we compared estimates of treatment effect between the two designs. When multiple observational studies or RCTs were identified for the same topic, we performed a meta-analysis and used the summary relative risk for comparisons. We matched 21 observational studies investigating 17 distinct clinical topics to 63 RCTs (median = 3 RCTs per observational study) for short-term (7 topics) and long-term (10 topics) mortality. Estimates from PS analyses differed statistically significantly from randomized evidence in two instances; however, observational studies reported more extreme beneficial treatment effects compared with RCTs in 13 of 17 instances (P = 0.049). Sensitivity analyses limited to large RCTs, and using alternative meta-analysis models yielded similar results. Conclusion For the treatment of ACS, observational studies using PS methods produce treatment effect estimates that are of more extreme magnitude compared with those from RCTs, although the differences are rarely statistically significant. PMID:22711757

A first step to compare geodynamical models and seismic observations of the inner core

NASA Astrophysics Data System (ADS)

Lasbleis, M.; Waszek, L.; Day, E. A.

2016-12-01

Seismic observations have revealed a complex inner core, with lateral and radial heterogeneities at all observable scales. The dominant feature is the east-west hemispherical dichotomy in seismic velocity and attenuation. Several geodynamical models have been proposed to explain the observed structure: convective instabilities, external forces, crystallisation processes or influence of outer core convection. However, interpreting such geodynamical models in terms of the seismic observations is difficult, and has been performed only for very specific models (Geballe 2013, Lincot 2014, 2016). Here, we propose a common framework to make such comparisons. We have developed a Python code that propagates seismic ray paths through kinematic geodynamical models for the inner core, computing a synthetic seismic data set that can be compared to seismic observations. Following the method of Geballe 2013, we start with the simple model of translation. For this, the seismic velocity is proposed to be function of the age or initial growth rate of the material (since there is no deformation included in our models); the assumption is reasonable when considering translation, growth and super rotation of the inner core. Using both artificial (random) seismic ray data sets and a real inner core data set (from Waszek et al. 2011), we compare these different models. Our goal is to determine the model which best matches the seismic observations. Preliminary results show that super rotation successfully creates an eastward shift in properties with depth, as has been observed seismically. Neither the growth rate of inner core material nor the relationship between crystal size and seismic velocity are well constrained. Consequently our method does not directly compute the seismic travel times. Instead, here we use age, growth rate and other parameters as proxies for the seismic properties, which represent a good first step to compare geodynamical and seismic observations.Ultimately we aim

Assessment of the quality of reporting observational studies in the pediatric dental literature.

PubMed

Butani, Yogita; Hartz, Arthur; Levy, Steven; Watkins, Catherine; Kanellis, Michael; Nowak, Arthur

2006-01-01

The purpose of this assessment was to evaluate reporting of observational studies in the pediatric dental literature. This assessment included the following steps: (1) developing a model for reporting information in clinical dentistry studies; (2) identifying treatment comparisons in pediatric dentistry that were evaluated by at least 5 observational studies; (3) abstracting from these studies any data indicated by applying the reporting model; and (4) comparing available data elements to the desired data elements in the reporting model. The reporting model included data elements related to: (1) patients; (2) providers; (3) treatment details; and (4) study design. Two treatment comparisons in pediatric dentistry were identified with 5 or more observational studies: (1) stainless steel crowns vs amalgams (10 studies); and (2) composite restorations vs amalgam (5 studies). Results from studies comparing the same treatments varied substantially. Data elements from the reporting model that could have explained some of the variation were often reported inadequately or not at all. Reporting of observational studies in the pediatric dental literature may be inadequate for an informed interpretation of the results. Models similar to that used in this study could be used for developing standards for the conduct and reporting of observational studies in pediatric dentistry.

Comparing GOSAT Observations of Localized CO2 Enhancements by Large Emitters with Inventory-Based Estimates

NASA Technical Reports Server (NTRS)

Janardanan, Rajesh; Maksyutov, Shamil; Oda, Tomohiro; Saito, Makoto; Kaiser, Johannes W.; Ganshin, Alexander; Stohl, Andreas; Matsunaga, Tsuneo; Yoshida, Yukio; Yokota, Tatsuya

2016-01-01

We employed an atmospheric transport model to attribute column-averaged CO2 mixing ratios (XCO2) observed by Greenhouse gases Observing SATellite (GOSAT) to emissions due to large sources such as megacities and power plants. XCO2 enhancements estimated from observations were compared to model simulations implemented at the spatial resolution of the satellite observation footprint (0.1deg × 0.1deg). We found that the simulated XCO2 enhancements agree with the observed over several continental regions across the globe, for example, for North America with an observation to simulation ratio of 1.05 +/- 0.38 (p<0.1), but with a larger ratio over East Asia (1.22 +/- 0.32; p<0.05). The obtained observation-model discrepancy (22%) for East Asia is comparable to the uncertainties in Chinese emission inventories (approx.15%) suggested by recent reports. Our results suggest that by increasing the number of observations around emission sources, satellite instruments like GOSAT can provide a tool for detecting biases in reported emission inventories.

German adjuvant intergroup node-positive study: a phase III trial to compare oral ibandronate versus observation in patients with high-risk early breast cancer.

PubMed

von Minckwitz, Gunter; Möbus, Volker; Schneeweiss, Andreas; Huober, Jens; Thomssen, Christoph; Untch, Michael; Jackisch, Christian; Diel, Ingo J; Elling, Dirk; Conrad, Bettina; Kreienberg, Rolf; Müller, Volkmar; Lück, Hans-Joachim; Bauerfeind, Ingo; Clemens, Michael; Schmidt, Marcus; Noeding, Stefanie; Forstbauer, Helmut; Barinoff, Jana; Belau, Antje; Nekljudova, Valentina; Harbeck, Nadia; Loibl, Sibylle

2013-10-01

Bisphosphonates prevent skeletal-related events in patients with metastatic breast cancer. Their effect in early breast cancer is controversial. Ibandronate is an orally and intravenously available amino-bisphosphonate with a favorable toxicity profile. It therefore qualifies as potential agent for adjuvant use. The GAIN (German Adjuvant Intergroup Node-Positive) study was an open-label, randomized, controlled phase III trial with a 2 × 2 factorial design. Patients with node-positive early breast cancer were randomly assigned 1:1 to two different dose-dense chemotherapy regimens and 2:1 to ibandronate 50 mg per day orally for 2 years or observation. In all, 2,640 patients and 728 events were estimated to be required to demonstrate an increase in disease-free survival (DFS) by ibandronate from 75% to 79.5% by using a two-sided α = .05 and 1-β of 80%. We report here the efficacy analysis for ibandronate, which was released by the independent data monitoring committee because the futility boundary was not crossed after 50% of the required DFS events were observed. Between June 2004 and August 2008, 2,015 patients were randomly assigned to ibandronate and 1,008 to observation. Patients randomly assigned to ibandronate showed no superior DFS or overall survival (OS) compared with patients randomly assigned to observation (DFS: hazard ratio, 0.945; 95% CI, 0.768 to 1.161; P = .589; OS: HR, 1.040; 95% CI, 0.763 to 1.419; P = .803). DFS was numerically longer if ibandronate was used in patients younger than 40 years or older than 60 years compared with patients age 40 to 59 years (test for interaction P = .093). Adjuvant treatment with oral ibandronate did not improve outcome of patients with high-risk early breast cancer who received dose-dense chemotherapy.

Comparing Aircraft Observations of Snowfall to Forecasts Using Single or Two Moment Bulk Water Microphysics Schemes

NASA Technical Reports Server (NTRS)

Molthan, Andrew L.

2010-01-01

High resolution weather forecast models with explicit prediction of hydrometeor type, size distribution, and fall speed may be useful in the development of precipitation retrievals, by providing representative characteristics of frozen hydrometeors. Several single or double-moment microphysics schemes are currently available within the Weather Research and Forecasting (WRF) model, allowing for the prediction of up to three ice species. Each scheme incorporates different assumptions regarding the characteristics of their ice classes, particularly in terms of size distribution, density, and fall speed. In addition to the prediction of hydrometeor content, these schemes must accurately represent the vertical profile of water vapor to account for possible attenuation, along with the size distribution, density, and shape characteristics of ice crystals that are relevant to microwave scattering. An evaluation of a particular scheme requires the availability of field campaign measurements. The Canadian CloudSat/CALIPSO Validation Project (C3VP) obtained measurements of ice crystal shapes, size distributions, fall speeds, and precipitation during several intensive observation periods. In this study, C3VP observations obtained during the 22 January 2007 synoptic-scale snowfall event are compared against WRF model output, based upon forecasts using four single-moment and two double-moment schemes available as of version 3.1. Schemes are compared against aircraft observations by examining differences in size distribution, density, and content. In addition to direct measurements from aircraft probes, simulated precipitation can also be converted to equivalent, remotely sensed characteristics through the use of the NASA Goddard Satellite Data Simulator Unit. Outputs from high resolution forecasts are compared against radar and satellite observations emphasizing differences in assumed crystal shape and size distribution characteristics.

Wave-induced boundary-layer separation: A case study comparing airborne observations and results from a mesoscale model

NASA Astrophysics Data System (ADS)

Strauss, L.; Serafin, S.; Grubišić, V.

2012-04-01

Wave-induced boundary-layer separation (BLS) results from the adverse-pressure gradient forces that are exerted on the atmospheric boundary-layer by internal gravity waves in flow over orography. BLS has received significant attention in recent years, particularly so, because it is a key ingredient in the formation of atmospheric rotors. Traditionally depicted as horizontal eddies in the lee of mountain ranges, rotors originate from the interaction between internal gravity waves and the atmospheric boundary-layer. Our study focuses on the first observationally documented case of wave-induced BLS, which occurred on 26 Jan 2006 in the lee of the Medicine Bow Mountains in SE Wyoming (USA). Observations from the University of Wyoming King Air (UWKA) aircraft, in particular, the remote sensing measurements with the Wyoming Cloud Radar (WCR), reveal strong wave activity, downslope winds in excess of 30 m/s, and near-surface flow reversal in the lee of the mountain range. The fine resolution of WCR data (on the order of 40x40 m2 for two-dimensional velocity fields) exhibits fine-scale vortical structures ("subrotors") which are embedded within the main rotor zone. Our case study intends to complete the characterisation of the observed boundary-layer separation event. Modelling of the event with the mesoscale Weather Research and Forecast Model (WRF) provides insight into the mesoscale triggers of wave-induced BLS and turbulence generation. Indeed, the mesoscale model underpins the expected concurrence of the essential processes (gravity waves, wave breaking, downslope windstorms, etc.) leading to BLS. To exploit the recorded in situ and radar data to their full extent, a quantitative evaluation of the structure and intensity of turbulence is conducted by means of a power spectral analysis of the vertical wind component, measured along the flight track. An intercomparison of observational and modelling results serves the purpose of model verification and can shed some more

Modified directly observed treatment for tuberculosis versus self-administered therapy: an observational study in rural Greece.

PubMed

Charokopos, N; Tsiros, G; Foka, A; Voila, P; Chrysanthopoulos, K; Spiliopoulou, I; Jelastopulu, E

2013-01-01

Directly Observed Treatment (DOT) is the key element of DOTS (directly observed treatment, short course), part of the internationally recommended control strategy for tuberculosis (TB). The evaluation of DOT has not been widely evaluated in rural areas in developed settings. The aim of this pilot study was to evaluate a modified DOT program (MDOT) by a general practitioner (GP) in a rural area of southwest Greece, where there is substantial underreporting of TB cases. Thirteen new TB cases with 30 close contacts were compared with 41 past-treated TB subjects (controls) with 111 close contacts in this observational, case-control study. Home visits by a GP were conducted and comparison of various data (laboratory findings, treatment outcomes, questionnaire-based parameters, on-site recorded conditions) was performed in both newly detected pulmonary TB cases and previously treated TB cases managed without DOT intervention. MDOT by GP implementation revealed that 11 cases (84.6%) were successfully treated, one (7.7%) case died, and one (7.7%) was lost to follow up. None of the close contacts of new TB cases was infected with active TB, while 6.3% of previously-treated TB subjects were infected with active TB and had to receive a complete anti-TB regimen. Chemoprophylaxis was administered to 13.3% of close contacts of new cases; whereas 12.6% of close contacts of previously-treated patients received chemoprophylaxis. This pilot study revealed that a GP is able to implement a program based on DOT resulting in high treatment adherence and prevention of TB compared with the conventional self-administration of treatment.

Comparative study on histological structures of the vitelline membrane of hen and duck egg observed by cryo-scanning electron microscopy.

PubMed

Chung, Wen-Hsin; Lai, Kung-Ming; Hsu, Kuo-chiang

2010-02-10

The histological structures of the vitelline membranes (VM) of hen and duck eggs were observed by cryo-scanning electron microscopy (cryo-SEM), and the chemical characteristics were also compared. The outer layer surface (OLS) of duck egg VM showed networks constructed by fibrils and sheets (0.1-5.2 microm in width), and that of hen egg presented networks formed only by sheets (2-6 microm in width). Thicker fibrils (0.5-1.5 microm in width) with different arrangement were observed on the inner layer surface (ILS) of duck egg VM as compared to those (0.3-0.7 microm in width) of hen egg VM. Upon separation, the outer surface of the outer layer (OSOL) and the inner surface of the inner layer (ISIL) of hen and duck egg VMs were quite similar to fresh VM except that the OSOL of duck egg VM showed networks constructed only by sheets. Thin fibrils interlaced above a bumpy or flat structure were observed at the exposed surface of the outer layer (ESOL) of hen and duck egg VMs. The exposed surfaces of inner layers (ESIL) of hen and duck egg VMs showed similar structures of fibrils, which joined, branched, and ran in straight lines for long distances up to 30 microm; however, the widths of the fibrils shown in ESOL and ESIL of duck egg VM were 0.1 and 0.7-1.4 microm, respectively, and were greater than those (<0.1 and 0.5-0.8 microm) of hen egg VM. The continuous membranes of both hen and duck egg VMs were still attached to the outer layers when separated. The content of protein, the major component of VM, was higher in duck egg VM (88.6%) than in hen egg VM (81.6%). Four and six major SDS-soluble protein patterns with distinct localization were observed in hen and duck egg VMs, respectively. Overall, the different histological structures of hen and duck egg VMs were suggested to be majorly attributable to the diverse protein components.

Overload and neovascularization of Achilles tendons in young artistic and rhythmic gymnasts compared with controls: an observational study.

PubMed

Notarnicola, A; Maccagnano, G; Di Leo, M; Tafuri, S; Moretti, B

2014-08-01

The incidence of Achilles tendinopathy is very high in young female gymnasts (17.5 %). According to literature, ecography screenings show the tendons thickening, but at the same time it does not reveal a direct link to the clinical picture. The neovessels are involved in the pathophysiological process of Achilles tendinopathy. For this reason, we wanted to verify there between perfusion tendon values and the type of sport activity. We performed a clinical observational study monitoring the oximetry of the Achilles tendon and the epidemiological data of 52 elite female (artistic and rhythmic) gymnasts versus 21 age-matched controls. Analyzing the main limb, we revealed statistically higher oximetry values in the artistic gymnasts group (69.5 %) compared to the rhythmic gymnasts group (67.1 %) (t = 2.13; p = 0.01) and the sedentary group (66.2 %) (t = 2.70; p = 0.004), but we did not find any differences between rhythmic gymnasts group and the sedentary group (t = 0.68; p = 0.24). The multiple logistic regression model highlighted that the oximetry value of the main limb is not influenced by age, knowledge of the main limb, years of general and gymnastic sports activity (p > 0.05). We discovered an increase of Achilles tendon perfusion in the main limb in the artistic gymnast group. We hypothesize that specific figures of artistic sports activity are responsible for muscle overload and gastrocnemius-soleus group and, at the same time, these figures cause hyperperfusion of the tendon. Prospective longitudinal studies could explain if this could become a predictive sign of the next Achilles tendinopathy onset.

Efficacy, tolerability and consumer acceptability of terbinafine topical spray versus terbinafine topical solution: a phase IIa, randomised, observer-blind, comparative study.

PubMed

Brown, Marc; Evans, Charles; Muddle, Andrew; Turner, Rob; Lim, Sian; Reed, Jessica; Traynor, Matt

2013-10-01

Tinea pedis is one of the world's most prevalent dermatophyte infections. MedSpray™ tinea pedis 1 % w/w (topical spray) is a novel, easy-to-use propellant-based spray formulation containing 1 % w/w terbinafine, requiring no manipulation at the site of infection. This is in contrast to the only formulation currently approved in Europe for single application (none are approved in the USA for single use), which is Lamisil(®) Once 1 % w/w (topical solution), containing 1 % w/w terbinafine hydrochloride, which requires manipulation on the affected area. The aim of this study was to evaluate the efficacy, tolerability and consumer acceptability of a topical spray versus a topical solution in the treatment of tinea pedis. This study is a phase IIa, randomised, observer-blind, non-inferiority comparative study of the topical spray compared with the topical solution over a 12-week study period. The study was conducted at Bioskin GmbH, Hamburg and Berlin. Patients (n = 120) who presented with the presence of interdigital tinea pedis caused by dermatophytes on one or both feet were enrolled in the study. Patients were randomly assigned between the two treatment groups. Either the topical spray or the topical solution was administered by the study nurse and consisted of a single application (equivalent to 20 mg of terbinafine per foot) on day 1 of the study. No further applications were made for the duration of the study. The hypothesis formulated before commencement of the study was that the topical spray would prove to be non-inferior to the topical solution. Efficacy assessments, including clinical signs and symptoms, mycology and microscopy were performed at baseline and 1, 6 and 12 weeks after treatment. The rate of mycological cure at week 1 was statistically equivalent for both treatments. There was a significant reduction in the overall clinical score as assessed by the Physician's Global Assessment of signs and symptoms for both treatment groups. The topical

Tensile strength of biological fibrin sealants: a comparative study.

PubMed

Lacaze, Laurence; Le Dem, Nicolas; Bubenheim, Michael; Tsilividis, Basile; Mezghani, Julien; Schwartz, Lilian; Francois, Arnaud; Ertaud, Jean Yves; Bagot d'Arc, Maurice; Scotté, Michel

2012-08-01

Fibrin sealants are commonly used in liver surgery, although their effectiveness in routine clinical practice remains controversial. Individual sealant characteristics are based on hemostatic effects and adhesion properties that can be experimentally measured using the 'rat skin test' or the 'pig skin test'. This study used a more relevant and realistic experimental canine model to compare the differences in the adhesive properties of four fibrin sealants in hepatectomy: Tisseel/Tissucol, Tachosil, Quixil, and Beriplast. A partial hepatectomy was performed in beagle dogs under general anesthesia to obtain liver cross-sections. Fibrin sealants were allocated to dog livers using a Youden square design. The tensile strength measurement was performed using a traction system to measure the rupture stress point of a small wooden cylinder bonded to the liver cross-section. Significantly greater adhesion properties were observed with Tisseel/Tissucol compared with Quixil or Beriplast (P = 0.002 and 0.001, respectively). Similarly, Tachosil demonstrated significantly greater adhesive properties compared with Beriplast (P = 0.009) or Quixil (P = 0.014). No significant differences were observed between Tisseel/Tissucol and Tachosil or between Beriplast and Quixil. The results of this comparative study demonstrate that different fibrin sealants exhibit different adhesive properties. Tisseel/Tissucol and Tachosil provided greatest adhesion to liver cross-section in our canine model of hepatectomy. These results may enable the optimal choice of fibrin sealants for this procedure in clinical practice. Copyright © 2012 Elsevier Inc. All rights reserved.

A comparative analysis of the effectiveness of active versus passive atrial lead fixation in Chinese patients with cardiac implantable electrical devices: a long term, retrospective, observational, single-center study.

PubMed

Hao, Yinglu; Li, Yanping; Liao, Derong; Yang, Ling; Liu, Fangyan

2017-03-01

Data comparing active atrial lead fixation with passive atrial lead fixation in Chinese patients with cardiovascular implantable electronic devices (CIEDs) for atrial pacing is limited. Our study evaluated the effectiveness of active fixation versus passive fixation of atrial leads by observing the lead performance parameters. This retrospective, long-term, single-center study included a cohort of Chinese patients who underwent CIED implantation at the Department of Cardiology of People's Hospital of Yuxi City, China, from 1 March 2010 to 1 March 2015. Efficacy was determined by comparing implantation time, threshold values, incidence of lead dislocation/failure, and lead-related complications between the two groups. Of the 1217 patients, active and passive atrial lead fixation were performed in 530 (mean age, 69.37 ± 11.44 years) and 497 (mean age, 68.33 ± 10.96 years). The active fixation group reported significantly lower mean atrial implantation times (P = .0001) and threshold values (P = .044) compared with the passive atrial lead fixation group. In addition, threshold values in the active atrial lead fixation group were stable throughout the observation period. No instances of myocardial perforation, cardiac tamponade, implantation failure, or electrode dislocation/re-fixation were reported in the active atrial lead fixation group. A favorable decrease in patient comfort parameters such as bed rest time (P = .027) and duration of hospital stay (P = .038) were also observed in the active lead fixation group. Active atrial lead fixation demonstrated greater stability, steady long-term thresholds and minimal lead-related complications compared to passive lead fixation in Chinese patients with CIEDs.

Comparative effectiveness analysis of anticoagulant strategies in a large observational database of percutaneous coronary interventions.

PubMed

Wise, Gregory R; Schwartz, Brian P; Dittoe, Nathaniel; Safar, Ammar; Sherman, Steven; Bowdy, Bruce; Hahn, Harvey S

2012-06-01

Percutaneous coronary intervention (PCI) is the most commonly used procedure for coronary revascularization. There are multiple adjuvant anticoagulation strategies available. In this era of cost containment, we performed a comparative effectiveness analysis of clinical outcomes and cost of the major anticoagulant strategies across all types of PCI procedures in a large observational database. A retrospective, comparative effectiveness analysis of the Premier observational database was conducted to determine the impact of anticoagulant treatment on outcomes. Multiple linear regression and logistic regression models were used to assess the association of initial antithrombotic treatment with outcomes while controlling for other factors. A total of 458,448 inpatient PCI procedures with known antithrombotic regimen from 299 hospitals between January 1, 2004 and March 31, 2008 were identified. Compared to patients treated with heparin plus glycoprotein IIb/IIIa inhibitor (GPI), bivalirudin was associated with a 41% relative risk reduction (RRR) for inpatient mortality, a 44% RRR for clinically apparent bleeding, and a 37% RRR for any transfusion. Furthermore, treatment with bivalirudin alone resulted in a cost savings of $976 per case. Similar results were seen between bivalirudin and heparin in all end-points. Combined use of both bivalirudin and GPI substantially attenuated the cost benefits demonstrated with bivalirudin alone. Bivalirudin use was associated with both improved clinical outcomes and decreased hospital costs in this large "real-world" database. To our knowledge, this study is the first to demonstrate the ideal comparative effectiveness end-point of both improved clinical outcomes with decreased costs in PCI. ©2012, Wiley Periodicals, Inc.

Hypomagnesemia associated with hypocalcemia after total thyroidectomy: an observational study.

PubMed

Mahmoud, Renata Regina da Graça Lorencetti; Neto, Vergilius José Furtado de Araujo; Alves, Wellington; Lin, Chin Shien; Leite, Ana Kober Nogueira; Matos, Leandro Luongo; Filho, Vergilius José Furtado de Araujo; Cernea, Claudio Roberto

2016-06-01

Serum magnesium is frequently low in patients with hypocalcemia after total thyroidectomy. The aim of the present study was to analyze the variations in serum magnesium and calcium concentrations after total thyroidectomy, and the relationship between both ions. We conducted an observational study of 142 patients who had undergone total thyroidectomy, measuring serum calcium and magnesium levels preoperatively and on the day following surgery. The incidence of postoperative hypocalcemia was compared with that of postoperative hypomagnesemia. A total of 142, total thyroidectomies were performed: 54 patients (38%) presented with hypocalcemia on the first postoperative day. A marked decrease in blood magnesium in the group of patients with hypocalcemia was observed when compared to those with normal calcemia on the first postoperative day (mean variation respectively, 0.125 ± 0.065 mmol/L versus 0.035 ± 0.020 mmol/L; P = 0.0002). Hypomagnesemia is significantly associated with early hypocalcemia following thyroidectomy.

Comparing Observations, 1st Experimental Edition.

ERIC Educational Resources Information Center

Butts, David P.

Objectives for this module include the ability to: (1) order objects by comparing a property which the objects have in common (such as length, area, volume or mass), (2) describe objects (length, area, volume, mass, etc.) by comparing them quantitatively using either arbitrary units of comparison or standard units of comparison, and (3) describe…

Solar system exploration from the Moon: Synoptic and comparative study of bodies in our Planetary system

NASA Technical Reports Server (NTRS)

Bruston, P.; Mumma, M. J.

1994-01-01

An observational approach to Planetary Sciences and exploration from Earth applies to a quite limited number of targets, but most of these are spatially complex, and exhibit variability and evolution on a number of temporal scales which lie within the scope of possible observations. Advancing our understanding of the underlying physics requires the study of interactions between the various elements of such systems, and also requires study of the comparative response of both a given object to various conditions and of comparable objects to similar conditions. These studies are best conducted in 'campaigns', i.e. comprehensive programs combining simultaneous coherent observations of every interacting piece of the puzzle. The requirements include both imaging and spectroscopy over a wide spectral range, from UV to IR. While temporal simultaneity of operation in various modes is a key feature, these observations are also conducted over extended periods of time. The moon is a prime site offering long unbroken observation times and high positional stability, observations at small angular separation from the sun, comparative studies of planet Earth, and valuable technical advantages. A lunar observatory should become a central piece of any coherent set of planetary missions, supplying in-situ explorations with the synoptic and comparative data necessary for proper advance planning, correlative observations during the active exploratory phase, and follow-up studies of the target body or of related objects.

Comparing methods for estimation of heterogeneous treatment effects using observational data from health care databases.

PubMed

Wendling, T; Jung, K; Callahan, A; Schuler, A; Shah, N H; Gallego, B

2018-06-03

There is growing interest in using routinely collected data from health care databases to study the safety and effectiveness of therapies in "real-world" conditions, as it can provide complementary evidence to that of randomized controlled trials. Causal inference from health care databases is challenging because the data are typically noisy, high dimensional, and most importantly, observational. It requires methods that can estimate heterogeneous treatment effects while controlling for confounding in high dimensions. Bayesian additive regression trees, causal forests, causal boosting, and causal multivariate adaptive regression splines are off-the-shelf methods that have shown good performance for estimation of heterogeneous treatment effects in observational studies of continuous outcomes. However, it is not clear how these methods would perform in health care database studies where outcomes are often binary and rare and data structures are complex. In this study, we evaluate these methods in simulation studies that recapitulate key characteristics of comparative effectiveness studies. We focus on the conditional average effect of a binary treatment on a binary outcome using the conditional risk difference as an estimand. To emulate health care database studies, we propose a simulation design where real covariate and treatment assignment data are used and only outcomes are simulated based on nonparametric models of the real outcomes. We apply this design to 4 published observational studies that used records from 2 major health care databases in the United States. Our results suggest that Bayesian additive regression trees and causal boosting consistently provide low bias in conditional risk difference estimates in the context of health care database studies. Copyright © 2018 John Wiley & Sons, Ltd.

Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy.

PubMed

Westra, Henny A

2011-02-01

Self-report measures of motivation for changing anxiety have been weakly and inconsistently related to outcome in cognitive behavioral therapy (CBT). While clients may not be able to accurately report their motivation, ambivalence about change may nonetheless be expressed in actual therapy sessions as opposition to the direction set by the therapist (i.e., resistance). In the context of CBT for generalized anxiety disorder, the present study compared the ability of observed in-session resistance in CBT session 1 and two self-report measures of motivation for changing anxiety (the Change Questionnaire & the Client Motivational for Therapy Scale) to (1) predict client and therapist rated homework compliance (2) predict post-CBT and one-year post-treatment worry reduction, and (3) differentiate those who received motivational interviewing prior to CBT from those who received no pre-treatment. Observed in-session resistance performed very well on each index, compared to the performance of self-reported motivation which was inconsistent and weaker relative to observed resistance. These findings strongly support both clinician sensitivity to moments of client resistance in actual therapy sessions as early as session 1, and the inclusion of observational process measures in CBT research. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

A comparative hospital-based observational study of mono- and co-infections of malaria, dengue virus and scrub typhus causing acute undifferentiated fever.

PubMed

Ahmad, S; Dhar, M; Mittal, G; Bhat, N K; Shirazi, N; Kalra, V; Sati, H C; Gupta, V

2016-04-01

Positive serology for dengue and/or scrub typhus infection with/without positive malarial smear (designated as mixed or co-infection) is being increasingly observed during epidemics of acute undifferentiated febrile illnesses (AUFIs). We planned to study the clinical and biochemical spectrum of co-infections with Plasmodium sp., dengue virus and scrub typhus and compare these with mono-infection by the same organisms. During the period from December 2012 to December 2013, all cases presenting with AUFIs to a single medical unit of a referral centre in Garhwal region of the north Indian state of Uttarakhand were retrospectively selected and categorised aetiologically as co-infections, malaria, dengue or scrub typhus. The groups thus created were compared in terms of demographic, clinical, biochemical and outcome parameters. The co-infection group (n = 49) was associated with milder clinical manifestations, fewer, milder and non-progressive organ dysfunction, and lesser need for intensive care, mechanical ventilation and dialysis as compared to mono-infections. When co-infections were sub-grouped and compared with the relevant mono-infections, there were differences in certain haematological and biochemical parameters; however, this difference did not translate into differential outcomes. Scrub typhus mono-infection was associated with severe disease in terms of both morbidity and mortality. Malaria, dengue and scrub typhus should be routinely tested in all patients with AUFIs. Co-infections, whether true or due to serological cross-reactivity, appear to be a separate entity so far as presentation and morbidity is concerned. Further insight is needed into the mechanism and identification of the protective infection.

Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training.

PubMed

Siddiqui, Usman T; Khan, Anjum F; Shamim, Muhammad Shahzad; Hamid, Rana Shoaib; Alam, Muhammad Mehboob; Emaduddin, Muhammad

2014-01-01

A noncontrast computed tomography (CT) scan remains the initial radiological investigation of choice for a patient with suspected aneurysmal subarachnoid hemorrhage (aSAH). This initial scan may be used to derive key information about the underlying aneurysm which may aid in further management. The interpretation, however, is subject to the skill and experience of the interpreting individual. The authors here evaluate the interpretation of such CT scans by different individuals at different levels of training, and in two different specialties (Radiology and Neurosurgery). Initial nonontrast CT scan of 35 patients with aSAH was evaluated independently by four different observers. The observers selected for the study included two from Radiology and two from Neurosurgery at different levels of training; a resident currently in mid training and a resident who had recently graduated from training of each specialty. Measured variables included interpreter's suspicion of presence of subarachnoid blood, side of the subarachnoid hemorrhage, location of the aneurysm, the aneurysm's proximity to vessel bifurcation, number of aneurysm(s), contour of aneurysm(s), presence of intraventricular hemorrhage (IVH), intracerebral hemorrhage (ICH), infarction, hydrocephalus and midline shift. To determine the inter-observer variability (IOV), weighted kappa values were calculated. There was moderate agreement on most of the CT scan findings among all observers. Substantial agreement was found amongst all observers for hydrocephalus, IVH, and ICH. Lowest agreement rates were seen in the location of aneurysm being supra or infra tentorial. There were, however, some noteworthy exceptions. There was substantial to almost perfect agreement between the radiology graduate and radiology resident on most CT findings. The lowest agreement was found between the neurosurgery graduate and the radiology graduate. Our study suggests that although agreements were seen in the interpretation of some of

Whistler Observations on DEMETER Compared with Full Electromagnetic Wave Simulations

NASA Astrophysics Data System (ADS)

Compston, A. J.; Cohen, M.; Lehtinen, N. G.; Inan, U.; Linscott, I.; Said, R.; Parrot, M.

2014-12-01

Terrestrial Very Low Frequency (VLF) electromagnetic radiation, which strongly impacts the Van Allen radiation belt electron dynamics, is injected across the ionosphere into the Earth's plasmasphere from two primary sources: man-made VLF transmitters and lightning discharges. Numerical models of trans-ionospheric propagation of such waves remain unvalidated, and early models may have overestimated the absorption, hindering a comprehensive understanding of the global impact of VLF waves in the loss of radiation belt electrons. In an attempt to remedy the problem of a lack of accurate trans-ionospheric propagation models, we have used a full electromagnetic wave method (FWM) numerical code to simulate the propagation of lightning-generated whistlers into the magnetosphere and compared the results with whistlers observed on the DEMETER satellite and paired with lightning stroke data from the National Lightning Detection Network (NLDN). We have identified over 20,000 whistlers occuring in 14 different passes of DEMETER over the central United States during the summer of 2009, and 14,000 of those occured within the 2000 km x 2000 km simulation grid we used. As shown in the attached figure, which shows a histogram of the ratio of the simulated whistler energy to the measured whistler energy for the 14,000 whistlers we compared, the simulation tends to slightly underestimate the total whistler energy injected by about 5 dB. However, the simulation underestimates the DEMETER measurements more as one gets further from the source lightning stroke, so since the signal to noise ratio of more distant whistlers will be smaller, possibly additive noise in the DEMETER measurements (which of course is not accounted for in the model) may explain some of the observed discrepancy.

Applications of propensity score methods in observational comparative effectiveness and safety research: where have we come and where should we go?

PubMed

Borah, Bijan J; Moriarty, James P; Crown, William H; Doshi, Jalpa A

2014-01-01

Propensity score (PS) methods have proliferated in recent years in observational studies in general and in observational comparative effectiveness research (CER) in particular. PS methods are an important set of tools for estimating treatment effects in observational studies, enabling adjustment for measured confounders in an easy-to-understand and transparent way. This article demonstrates how PS methods have been used to address specific CER questions from 2001 through to 2012 by identifying six impactful studies from this period. This article also discusses areas for improvement, including data infrastructure, and a unified set of guidelines in terms of PS implementation and reporting, which will boost confidence in evidence generated through observational CER using PS methods.

Statistical properties of a utility measure of observer performance compared to area under the ROC curve

NASA Astrophysics Data System (ADS)

Abbey, Craig K.; Samuelson, Frank W.; Gallas, Brandon D.; Boone, John M.; Niklason, Loren T.

2013-03-01

The receiver operating characteristic (ROC) curve has become a common tool for evaluating diagnostic imaging technologies, and the primary endpoint of such evaluations is the area under the curve (AUC), which integrates sensitivity over the entire false positive range. An alternative figure of merit for ROC studies is expected utility (EU), which focuses on the relevant region of the ROC curve as defined by disease prevalence and the relative utility of the task. However if this measure is to be used, it must also have desirable statistical properties keep the burden of observer performance studies as low as possible. Here, we evaluate effect size and variability for EU and AUC. We use two observer performance studies recently submitted to the FDA to compare the EU and AUC endpoints. The studies were conducted using the multi-reader multi-case methodology in which all readers score all cases in all modalities. ROC curves from the study were used to generate both the AUC and EU values for each reader and modality. The EU measure was computed assuming an iso-utility slope of 1.03. We find mean effect sizes, the reader averaged difference between modalities, to be roughly 2.0 times as big for EU as AUC. The standard deviation across readers is roughly 1.4 times as large, suggesting better statistical properties for the EU endpoint. In a simple power analysis of paired comparison across readers, the utility measure required 36% fewer readers on average to achieve 80% statistical power compared to AUC.

Changes in quality of life after elective surgery: an observational study comparing two measures.

PubMed

Kronzer, Vanessa L; Jerry, Michelle R; Ben Abdallah, Arbi; Wildes, Troy S; McKinnon, Sherry L; Sharma, Anshuman; Avidan, Michael S

2017-08-01

Our main objective was to compare the change in a validated quality of life measure to a global assessment measure. The secondary objectives were to estimate the minimum clinically important difference (MCID) and to describe the change in quality of life by surgical specialty. This prospective cohort study included 7902 adult patients undergoing elective surgery. Changes in the Veterans RAND 12-Item Health Survey (VR-12), composed of a physical component summary (PCS) and a mental component summary (MCS), were calculated using preoperative and postoperative questionnaires. The latter also contained a global assessment question for quality of life. We compared PCS and MCS to the global assessment using descriptive statistics and weighted kappa. MCID was calculated using an anchor-based approach. Analyses were pre-specified and registered (NCT02771964). By the change in VR-12 scores, an equal proportion of patients experienced improvement and deterioration in quality of life (28% for PCS, 25% for MCS). In contrast, by the global assessment measure, 61% reported improvement, while only 10% reported deterioration. Agreement with the global assessment was slight for both PCS (kappa = 0.20, 57% matched) and MCS (kappa = 0.10, 54% matched). The MCID for the overall VR-12 score was approximately 2.5 points. Patients undergoing orthopedic surgery showed the most improvement in quality of life measures, while patients undergoing gastrointestinal/hepatobiliary or urologic surgery showed the most deterioration. Subjective global quality of life report does not agree well with a validated quality of life instrument, perhaps due to patient over-optimism.

Using data mining techniques to characterize participation in observational studies.

PubMed

Linden, Ariel; Yarnold, Paul R

2016-12-01

Data mining techniques are gaining in popularity among health researchers for an array of purposes, such as improving diagnostic accuracy, identifying high-risk patients and extracting concepts from unstructured data. In this paper, we describe how these techniques can be applied to another area in the health research domain: identifying characteristics of individuals who do and do not choose to participate in observational studies. In contrast to randomized studies where individuals have no control over their treatment assignment, participants in observational studies self-select into the treatment arm and therefore have the potential to differ in their characteristics from those who elect not to participate. These differences may explain part, or all, of the difference in the observed outcome, making it crucial to assess whether there is differential participation based on observed characteristics. As compared to traditional approaches to this assessment, data mining offers a more precise understanding of these differences. To describe and illustrate the application of data mining in this domain, we use data from a primary care-based medical home pilot programme and compare the performance of commonly used classification approaches - logistic regression, support vector machines, random forests and classification tree analysis (CTA) - in correctly classifying participants and non-participants. We find that CTA is substantially more accurate than the other models. Moreover, unlike the other models, CTA offers transparency in its computational approach, ease of interpretation via the decision rules produced and provides statistical results familiar to health researchers. Beyond their application to research, data mining techniques could help administrators to identify new candidates for participation who may most benefit from the intervention. © 2016 John Wiley & Sons, Ltd.

Comparing a Carbon Budget for the Amazon Basin Derived from Aircraft Observations

NASA Astrophysics Data System (ADS)

Chow, V. Y.; Dayalu, A.; Wofsy, S. C.; Gerbig, C.

2015-12-01

We present and compare a carbon budget for the Brazilian Amazon Basin based on the Balanço Atmosférico Regional de Carbono na Amazônia (BARCA) aircraft program, which occurred in November 2008 & May 2009, to other published carbon budgets. In particular, we compare our budget and analysis to others also derived from aircraft observations. Using mesoscale meteorological fields from ECMWF and WRF, we drive the Stochastic Time-Inverted Lagrangian Transport (STILT) model and couple the footprint, or influence, to a biosphere model represented by the Vegetation Photosynthesis Respiration Model (VPRM). Since it is the main driver for the VPRM, we use observed shortwave radiation from towers in Brazil and French Guyana to examine the modeled shortwave radiation data from GL 1.2 (a global radiation model based on GOES 8 visible imagery), ECMWF, and WRF to determine if there are any biases in the modeled shortwave radiation output. We use WRF-STILT and ECMWF-STILT, GL 1.2 shortwave radiation, temperature, and vegetation maps (IGBP and SYNMAP) updated by landuse scenarios modeled by Sim Amazonia 2 and Sim Brazil, to compute hourly a priori CO2 fluxes by calculating Gross Ecosystem Exchange and Respiration for the 4 significant vegetation types across two (wet and dry) seasons as defined by 10-years of averaged TRIMM precipitation data. SF6 from stations and aircraft observations are used to determine the anthropogenic CO2 background and the lateral boundary conditions are taken from CarbonTracker2013B. The BARCA aircraft mixing ratios are then used as a top down constraint in an inversion framework that solves for the parameters controlling the fluxes for each vegetation type. The inversion provides scaling factors for GEE and R for each vegetation type in each season. From there, we derive a budget for the Basin and compare/contrast with other published basinwide CO2 fluxes.

Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

PubMed

Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

2017-06-01

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

[Pregnancy-Associated Breast Cancer: An analytical observational study].

PubMed

Baulies, Sonia; Cusidó, Maite; Tresserra, Francisco; Rodríguez, Ignacio; Ubeda, Belén; Ara, Carmen; Fábregas, Rafael

2014-03-04

Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy and up to one year postpartum. A retrospective, analytical, observational study comparing 56 cases of breast cancer and pregnancy (PABC) diagnosed 1976-2008 with 73 patients with breast cancer not associated with pregnancy (non-PABC) was performed. Demographic data, prognostic factors, treatment and survival were reviewed and compared. The prevalence of PABC in our center is 8.3/10,000. The highest frequency (62%) appeared during the postpartum period. The stages are higher in PABC, being 31.3% advanced (EIII and EIV) in PABC versus 13.3% in non-PABC (P < .05). Regarding prognostic factors, 27.3% in PABC had a tumoral grade 3 versus 15.8% of non-PABC. Among women with PABC, 33.3% had negative estrogen receptors, 48.7% negative progesterone receptors and 34.5% positive Her2Neu compared with 22.2, 24.1 and 31%, respectively of non-PABC patients. Finally, positive lymph nodes were found in 52.8% of PABC, versus 33.8% non-PABC (P < .05). Overall and disease-free survival rate at 5 years for PABC was 63.7 and 74.2%, respectively. The poorer survival observed is possibly due to the presence of adverse prognostic features such as lymph node metastases, negative hormone receptors, tumoral grade iii, as well as a delay in diagnosis with a higher rate of advanced stages. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Osteoporosis therapies: evidence from health-care databases and observational population studies.

PubMed

Silverman, Stuart L

2010-11-01

Osteoporosis is a well-recognized disease with severe consequences if left untreated. Randomized controlled trials are the most rigorous method for determining the efficacy and safety of therapies. Nevertheless, randomized controlled trials underrepresent the real-world patient population and are costly in both time and money. Modern technology has enabled researchers to use information gathered from large health-care or medical-claims databases to assess the practical utilization of available therapies in appropriate patients. Observational database studies lack randomization but, if carefully designed and successfully completed, can provide valuable information that complements results obtained from randomized controlled trials and extends our knowledge to real-world clinical patients. Randomized controlled trials comparing fracture outcomes among osteoporosis therapies are difficult to perform. In this regard, large observational database studies could be useful in identifying clinically important differences among therapeutic options. Database studies can also provide important information with regard to osteoporosis prevalence, health economics, and compliance and persistence with treatment. This article describes the strengths and limitations of both randomized controlled trials and observational database studies, discusses considerations for observational study design, and reviews a wealth of information generated by database studies in the field of osteoporosis.

BAYESIAN TECHNIQUES FOR COMPARING TIME-DEPENDENT GRMHD SIMULATIONS TO VARIABLE EVENT HORIZON TELESCOPE OBSERVATIONS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Junhan; Marrone, Daniel P.; Chan, Chi-Kwan

2016-12-01

The Event Horizon Telescope (EHT) is a millimeter-wavelength, very-long-baseline interferometry (VLBI) experiment that is capable of observing black holes with horizon-scale resolution. Early observations have revealed variable horizon-scale emission in the Galactic Center black hole, Sagittarius A* (Sgr A*). Comparing such observations to time-dependent general relativistic magnetohydrodynamic (GRMHD) simulations requires statistical tools that explicitly consider the variability in both the data and the models. We develop here a Bayesian method to compare time-resolved simulation images to variable VLBI data, in order to infer model parameters and perform model comparisons. We use mock EHT data based on GRMHD simulations to explore themore » robustness of this Bayesian method and contrast it to approaches that do not consider the effects of variability. We find that time-independent models lead to offset values of the inferred parameters with artificially reduced uncertainties. Moreover, neglecting the variability in the data and the models often leads to erroneous model selections. We finally apply our method to the early EHT data on Sgr A*.« less

Bayesian Techniques for Comparing Time-dependent GRMHD Simulations to Variable Event Horizon Telescope Observations

NASA Astrophysics Data System (ADS)

Kim, Junhan; Marrone, Daniel P.; Chan, Chi-Kwan; Medeiros, Lia; Özel, Feryal; Psaltis, Dimitrios

2016-12-01

The Event Horizon Telescope (EHT) is a millimeter-wavelength, very-long-baseline interferometry (VLBI) experiment that is capable of observing black holes with horizon-scale resolution. Early observations have revealed variable horizon-scale emission in the Galactic Center black hole, Sagittarius A* (Sgr A*). Comparing such observations to time-dependent general relativistic magnetohydrodynamic (GRMHD) simulations requires statistical tools that explicitly consider the variability in both the data and the models. We develop here a Bayesian method to compare time-resolved simulation images to variable VLBI data, in order to infer model parameters and perform model comparisons. We use mock EHT data based on GRMHD simulations to explore the robustness of this Bayesian method and contrast it to approaches that do not consider the effects of variability. We find that time-independent models lead to offset values of the inferred parameters with artificially reduced uncertainties. Moreover, neglecting the variability in the data and the models often leads to erroneous model selections. We finally apply our method to the early EHT data on Sgr A*.

Comparative safety of direct oral anticoagulants and warfarin in venous thromboembolism: multicentre, population based, observational study.

PubMed

Jun, Min; Lix, Lisa M; Durand, Madeleine; Dahl, Matt; Paterson, J Michael; Dormuth, Colin R; Ernst, Pierre; Yao, Shenzhen; Renoux, Christel; Tamim, Hala; Wu, Cynthia; Mahmud, Salaheddin M; Hemmelgarn, Brenda R

2017-10-17

Objective  To determine the safety of direct oral anticoagulant (DOAC) use compared with warfarin use for the treatment of venous thromboembolism. Design  Retrospective matched cohort study conducted between 1 January 2009 and 31 March 2016. Setting  Community based, using healthcare data from six jurisdictions in Canada and the United States. Participants  59 525 adults (12 489 DOAC users; 47 036 warfarin users) with a new diagnosis of venous thromboembolism and a prescription for a DOAC or warfarin within 30 days of diagnosis. Main outcome measures  Outcomes included hospital admission or emergency department visit for major bleeding and all cause mortality within 90 days after starting treatment. Propensity score matching and shared frailty models were used to estimate adjusted hazard ratios of the outcomes comparing DOACs with warfarin. Analyses were conducted independently at each site, with meta-analytical methods used to estimate pooled hazard ratios across sites. Results  Of the 59 525 participants, 1967 (3.3%) had a major bleed and 1029 (1.7%) died over a mean follow-up of 85.2 days. The risk of major bleeding was similar for DOAC compared with warfarin use (pooled hazard ratio 0.92, 95% confidence interval 0.82 to 1.03), with the overall direction of the association favouring DOAC use. No difference was found in the risk of death (pooled hazard ratio 0.99, 0.84 to 1.16) for DOACs compared with warfarin use. There was no evidence of heterogeneity across centres, between patients with and without chronic kidney disease, across age groups, or between male and female patients. Conclusions  In this analysis of adults with incident venous thromboembolism, treatment with DOACs, compared with warfarin, was not associated with an increased risk of major bleeding or all cause mortality in the first 90 days of treatment. Trial registration  Clinical trials NCT02833987. Published by the BMJ Publishing Group Limited. For permission to use (where not

Task Equivalence for Model and Human-Observer Comparisons in SPECT Localization Studies

NASA Astrophysics Data System (ADS)

Sen, Anando; Kalantari, Faraz; Gifford, Howard C.

2016-06-01

While mathematical model observers are intended for efficient assessment of medical imaging systems, their findings should be relevant for human observers as the primary clinical end users. We have investigated whether pursuing equivalence between the model and human-observer tasks can help ensure this goal. A localization receiver operating characteristic (LROC) study tested prostate lesion detection in simulated In-111 SPECT imaging with anthropomorphic phantoms. The test images were 2D slices extracted from reconstructed volumes. The iterative ordered sets expectation-maximization (OSEM) reconstruction algorithm was used with Gaussian postsmoothing. Variations in the number of iterations and the level of postfiltering defined the test strategies in the study. Human-observer performance was compared with that of a visual-search (VS) observer, a scanning channelized Hotelling observer, and a scanning channelized nonprewhitening (CNPW) observer. These model observers were applied with precise information about the target regions of interest (ROIs). ROI knowledge was a study variable for the human observers. In one study format, the humans read the SPECT image alone. With a dual-modality format, the SPECT image was presented alongside an anatomical image slice extracted from the density map of the phantom. Performance was scored by area under the LROC curve. The human observers performed significantly better with the dual-modality format, and correlation with the model observers was also improved. Given the human-observer data from the SPECT study format, the Pearson correlation coefficients for the model observers were 0.58 (VS), -0.12 (CH), and -0.23 (CNPW). The respective coefficients based on the human-observer data from the dual-modality study were 0.72, 0.27, and -0.11. These results point towards the continued development of the VS observer for enhancing task equivalence in model-observer studies.

Comparative study of INPIStron and spark gap

NASA Technical Reports Server (NTRS)

Han, Kwang S.; Lee, Ja H.

1993-01-01

An inverse pinch plasma switch, INPIStron, was studied in comparison to a conventional spark gap. The INPIStron is under development for high power switching applications. The INPIStron has an inverse pinch dynamics, opposed to Z-pinch dynamics in the spark gap. The electrical, plasma dynamics and radiative properties of the closing plasmas have been studied. Recently the high-voltage pulse transfer capabilities or both the INPIStron and the spark gap were also compared. The INPIStron with a low impedance Z = 9 ohms transfers 87 percent of an input pulse with a halfwidth of 2 mu s. For the same input pulse the spark gap of Z = 100 ohms transfers 68 percent. Fast framing and streak photography, taken with an TRW image converter camera, was used to observe the discharge uniformity and closing plasma speed in both switches. In order to assess the effects of closing plasmas on erosion of electrode material, emission spectra of two switches were studied with a spectrometer-optical multi channel analyzer (OMA) system. The typical emission spectra of the closing plasmas in the INPIStron and the spark gap showed that there were comparatively weak carbon line emission in 658.7 nm and copper (electrode material) line emissions in the INPIStron, indicating low erosion of materials in the INPIStron.

A Comparative Investigation of the Efficiency of Two Classroom Observational Methods.

ERIC Educational Resources Information Center

Kissel, Mary Ann

The problem of this study was to determine whether Method A is a more efficient observational method for obtaining activity type behaviors in an individualized classroom than Method B. Method A requires the observer to record the activities of the entire class at given intervals while Method B requires only the activities of selected individuals…

Night Airglow Observations from Orbiting Spacecraft Compared with Measurements from Rockets.

PubMed

Koomen, M J; Gulledge, I S; Packer, D M; Tousey, R

1963-06-07

A luminous band around the night-time horizon, observed from orbiting capsules by J. H. Glenn and M. S. Carpenter, and identified as the horizon enhancement of the night airglow, is detected regularly in rocket-borne studies of night airglow. Values of luminance and dip angle of this band derived from Carpenter's observations agree remarkably well with values obtained from rocket data. The rocket results, however, do not support Carpenter's observation that the emission which he saw was largely the atomic oxygen line at 5577 A, but assign the principal luminosity to the green continuum.

The advances in airglow study and observation by the ground-based airglow observation network over China

NASA Astrophysics Data System (ADS)

Xu, Jiyao; Li, Qinzeng; Yuan, Wei; Liu, Xiao; Liu, Weijun; Sun, Longchang

2017-04-01

Ground-based airglow observation networks over China used to study airglow have been established, which contains 15 stations. Some new results were obtained using the networks. For OH airglow observations, firstly, an unusual outbreak of Concentric Gravity Wave (CGW) events were observed by the first no-gap network nearly every night during the first half of August 2013. Combination of the ground imager network with satellites provides multilevel observations of the CGWs from the troposphere to the mesopause region. Secondly, three-year OH airglow images (2012-2014) from Qujing (25.6°N, 103.7°E) were used to study how orographic features of the Tibetan Plateau (TP) affect the geographical distributions of gravity wave (GW) sources. We find the orographic forcings have a significant impact on the gravity wave propagation features. Thirdly, ground-based observations of the OH (9-4, 8-3, 6-2, 5-1, 3-0) band airglow over Xinglong (40°2N, 117°4E) in northern China from 2012 to 2014 are used to calculate rotational temperatures. By comparing the ground-based OH rotational temperature with SABER's observations, five Einstein coefficient datasets are evaluated. We find rotational temperatures determined using any of the available Einstein coefficient datasets have systematic errors. We have obtained a set of optimal Einstein coefficients ratios for rotational temperature derivation using three years data from ground-based OH spectra and SABER temperatures. For the OI 630.0 nm airglow observations, we used three-year (2011-2013) observations of thermospheric winds (at 250 km) by Fabry-Perot interferometers at Xinglong to study the climatology of atmospheric planetary wave-type oscillations (PWTOs) with periods of 4-19 days. We found these PWTOs occur more frequently in the months from May to October. They are consistent with the summertime preference of middle-latitude ionospheric electron density oscillations noted in other studies. By using an all-sky airglow imager

Comparability of automated human induced pluripotent stem cell culture: a pilot study.

PubMed

Archibald, Peter R T; Chandra, Amit; Thomas, Dave; Chose, Olivier; Massouridès, Emmanuelle; Laâbi, Yacine; Williams, David J

2016-12-01

Consistent and robust manufacturing is essential for the translation of cell therapies, and the utilisation automation throughout the manufacturing process may allow for improvements in quality control, scalability, reproducibility and economics of the process. The aim of this study was to measure and establish the comparability between alternative process steps for the culture of hiPSCs. Consequently, the effects of manual centrifugation and automated non-centrifugation process steps, performed using TAP Biosystems' CompacT SelecT automated cell culture platform, upon the culture of a human induced pluripotent stem cell (hiPSC) line (VAX001024c07) were compared. This study, has demonstrated that comparable morphologies and cell diameters were observed in hiPSCs cultured using either manual or automated process steps. However, non-centrifugation hiPSC populations exhibited greater cell yields, greater aggregate rates, increased pluripotency marker expression, and decreased differentiation marker expression compared to centrifugation hiPSCs. A trend for decreased variability in cell yield was also observed after the utilisation of the automated process step. This study also highlights the detrimental effect of the cryopreservation and thawing processes upon the growth and characteristics of hiPSC cultures, and demonstrates that automated hiPSC manufacturing protocols can be successfully transferred between independent laboratories.

Learning in the Making: A Comparative Case Study of Three Makerspaces

ERIC Educational Resources Information Center

Sheridan, Kimberly M.; Halverson, Erica Rosenfeld; Litts, Breanne K.; Brahms, Lisa; Jacobs-Priebe, Lynette; Owens, Trevor

2014-01-01

Through a comparative case study, Sheridan and colleagues explore how makerspaces may function as learning environments. Drawing on field observations, interviews, and analysis of artifacts, videos, and other documents, the authors describe features of three makerspaces and how participants learn and develop through complex design and making…

Ways of learning: Observational studies versus experiments

USGS Publications Warehouse

Shaffer, T.L.; Johnson, D.H.

2008-01-01

Manipulative experimentation that features random assignment of treatments, replication, and controls is an effective way to determine causal relationships. Wildlife ecologists, however, often must take a more passive approach to investigating causality. Their observational studies lack one or more of the 3 cornerstones of experimentation: controls, randomization, and replication. Although an observational study can be analyzed similarly to an experiment, one is less certain that the presumed treatment actually caused the observed response. Because the investigator does not actively manipulate the system, the chance that something other than the treatment caused the observed results is increased. We reviewed observational studies and contrasted them with experiments and, to a lesser extent, sample surveys. We identified features that distinguish each method of learning and illustrate or discuss some complications that may arise when analyzing results of observational studies. Findings from observational studies are prone to bias. Investigators can reduce the chance of reaching erroneous conclusions by formulating a priori hypotheses that can be pursued multiple ways and by evaluating the sensitivity of study conclusions to biases of various magnitudes. In the end, however, professional judgment that considers all available evidence is necessary to render a decision regarding causality based on observational studies.

Comparing the Scoring of Human Decomposition from Digital Images to Scoring Using On-site Observations.

PubMed

Dabbs, Gretchen R; Bytheway, Joan A; Connor, Melissa

2017-09-01

When in forensic casework or empirical research in-person assessment of human decomposition is not possible, the sensible substitution is color photographic images. To date, no research has confirmed the utility of color photographic images as a proxy for in situ observation of the level of decomposition. Sixteen observers scored photographs of 13 human cadavers in varying decomposition stages (PMI 2-186 days) using the Total Body Score system (total n = 929 observations). The on-site TBS was compared with recorded observations from digital color images using a paired samples t-test. The average difference between on-site and photographic observations was -0.20 (t = -1.679, df = 928, p = 0.094). Individually, only two observers, both students with <1 year of experience, demonstrated TBS statistically significantly different than the on-site value, suggesting that with experience, observations of human decomposition based on digital images can be substituted for assessments based on observation of the corpse in situ, when necessary. © 2017 American Academy of Forensic Sciences.

Comparative Packaging Study

NASA Technical Reports Server (NTRS)

Perchonok, Michele; Antonini, David

2008-01-01

This viewgraph presentation describes a comparative packaging study for use on long duration space missions. The topics include: 1) Purpose; 2) Deliverables; 3) Food Sample Selection; 4) Experimental Design Matrix; 5) Permeation Rate Comparison; and 6) Packaging Material Information.

Organizational Culture at High Schools in TRNC: A Comparative Case Study

ERIC Educational Resources Information Center

Silman, Fatos; Ozmatyatli, Icim Ozenli; Birol, Cem; Caglar, Mehmet

2012-01-01

This study was conducted to compare the organizational culture in two TRNC schools by using influencing factors of metaphors, physical environment, values, norms, rituals, language, legends and reward systems. To obtain data, a triangulation of participant interviews, observations and written sources were used. Results appear to display that the…

Comparative inter-institutional study of stress among dentists.

PubMed

Pozos-Radillo, Blanca E; Galván-Ramírez, Ma Luz; Pando, Manuel; Carrión, Ma De los Angeles; González, Guillermo J

2010-01-01

Dentistry is considered to be a stressful profession due to different factors caused by work, representing a threat to dentists'health. The objectives of this work were to identify and compare chronic stress in dentists among the different health institutions and the association of stress with risk factors. The study in question is observational, transversal and comparative; 256 dentists were included, distributed among five public health institutions in the city of Guadalajara, Jalisco, Mexico, namely: the Mexican Institute of Social Security (IMSS), the Ministry of Health (SS), the Integral Development of the Family (DIF), the Social Security Services Institute for the Workers (ISSSTE) and the University of Guadalajara (U. de G) Data were obtained by means of the census technique. Stress was identified using the Stress Symptoms Inventory and the statistical analysis was performed using the Odds Ratio (O.R.) and the chi-square statistic. From the total population studied, 219 subjects presented high levels of chronic stress and 37, low levels. In the results of comparative analysis, significant differences were found between IMSS and U. de G and likewise between IMSS and SS. However, in the analysis of association, only U. de G was found to be associated with the high level of chronic stress.

Observational studies using propensity score analysis underestimated the effect sizes in critical care medicine.

PubMed

Zhang, Zhongheng; Ni, Hongying; Xu, Xiao

2014-08-01

Propensity score (PS) analysis has been increasingly used in critical care medicine; however, its validation has not been systematically investigated. The present study aimed to compare effect sizes in PS-based observational studies vs. randomized controlled trials (RCTs) (or meta-analysis of RCTs). Critical care observational studies using PS were systematically searched in PubMed from inception to April 2013. Identified PS-based studies were matched to one or more RCTs in terms of population, intervention, comparison, and outcome. The effect sizes of experimental treatments were compared for PS-based studies vs. RCTs (or meta-analysis of RCTs) with sign test. Furthermore, ratio of odds ratio (ROR) was calculated from the interaction term of treatment × study type in a logistic regression model. A ROR < 1 indicates greater benefit for experimental treatment in RCTs compared with PS-based studies. RORs of each comparison were pooled by using meta-analytic approach with random-effects model. A total of 20 PS-based studies were identified and matched to RCTs. Twelve of the 20 comparisons showed greater beneficial effect for experimental treatment in RCTs than that in PS-based studies (sign test P = 0.503). The difference was statistically significant in four comparisons. ROR can be calculated from 13 comparisons, of which four showed significantly greater beneficial effect for experimental treatment in RCTs. The pooled ROR was 0.71 (95% CI: 0.63, 0.79; P = 0.002), suggesting that RCTs (or meta-analysis of RCTs) were more likely to report beneficial effect for the experimental treatment than PS-based studies. The result remained unchanged in sensitivity analysis and meta-regression. In critical care literature, PS-based observational study is likely to report less beneficial effect of experimental treatment compared with RCTs (or meta-analysis of RCTs). Copyright © 2014 Elsevier Inc. All rights reserved.

Methodological Challenges When Comparing Demographic and Clinical Characteristics of International Observational Registries.

PubMed

Verstappen, Suzanne M M; Askling, Johan; Berglind, Niklas; Franzen, Stefan; Frisell, Thomas; Garwood, Christopher; Greenberg, Jeffrey D; Holmqvist, Marie; Horne, Laura; Lampl, Kathy; Michaud, Kaleb; Nyberg, Fredrik; Pappas, Dimitrios A; Reed, George; Symmons, Deborah P M; Tanaka, Eiichi; Tran, Trung N; Yamanaka, Hisashi; Ho, Meilien

2015-12-01

Comparisons of data from different registries can be helpful in understanding variations in many aspects of rheumatoid arthritis (RA). The study aim was to assess and improve the comparability of demographic, clinical, and comorbidity data from 5 international RA registries. Using predefined definitions, 2 subsets of patients (main cohort and subcohort) from 5 international observational registries (Consortium of Rheumatology Researchers of North America Registry [CORRONA], the Swedish Rheumatology Quality of Care Register [SRR], the Norfolk Arthritis Register [NOAR], the Institute of Rheumatology Rheumatoid Arthritis cohort [IORRA], and CORRONA International) were evaluated and compared. Patients ages >18 years with RA, and present in or recruited to the registry from January 1, 2000, were included in the main cohort. Patients from the main cohort with positive rheumatoid factor and/or erosive RA who had received ≥1 synthetic disease-modifying antirheumatic drug (DMARD), and switched to or added another DMARD, were included in the subcohort at time of treatment switch. Age and sex distributions were fairly similar across the registries. The percentage of patients with a high Disease Activity Score in 28 joints score varied between main cohorts (17.5% IORRA, 18.9% CORRONA, 24.7% NOAR, 27.7% CORRONA International, and 36.8% SRR), with IORRA, CORRONA, and CORRONA International including more prevalent cases of RA; the differences were smaller for the subcohort. Prevalence of comorbidities varied across registries (e.g., coronary artery disease ranged from 1.5% in IORRA to 7.9% in SRR), partly due to the way comorbidity data were captured and general cultural differences; the pattern was similar for the subcohorts. Despite different inclusion criteria for the individual RA registries, it is possible to improve the comparability and interpretability of differences across RA registries by applying well-defined cohort definitions. © 2015, American College of

Do physicians clean their hands? Insights from a covert observational study.

PubMed

Kovacs-Litman, Adam; Wong, Kimberly; Shojania, Kaveh G; Callery, Sandra; Vearncombe, Mary; Leis, Jerome A

2016-12-01

Physicians are notorious for poor hand hygiene (HH) compliance. We wondered if lower performance by physicians compared with other health professionals might reflect differences in the Hawthorne effect. We introduced covert HH observers to see if performance differences between physicians and nurses decreased and to gain further insights into physician HH behaviors. Following training and validation with a hospital HH auditor, 2 students covertly measured HH during clinical rotations. Students rotated off clinical services every week to increase exposure to different providers and minimize risk of exposing the covert observation. We compared covertly measured HH compliance with data from overt observation by hospital auditors during the same time period. Covert observation produced much lower HH compliance than recorded by hospital auditors during the same time period: 50.0% (799/1597) versus 83.7% (2769/3309) (P < 0.0002). The difference in physician compliance between hospital auditors and covert observers was 19.0% (73.2% vs 54.2%); for nurses this difference was much higher at 40.7% (85.8% vs 45.1%) (P < 0.0001). Physician trainees showed markedly better compliance when attending staff cleaned their hands compared with encounters when attending did not (79.5% vs 18.9%; P < 0.0002). Our study suggests that traditional HH audits not only overstate HH performance overall, but can lead to inaccurate inferences about performance by professional groupings due to relative differences in the Hawthorne effect. We suggest that future improvement efforts will rely on more accurate HH monitoring systems and strong attending physician leadership to set an example for trainees. Journal of Hospital Medicine 2015;11:862-864. © 2015 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

A randomized controlled study comparing community based with health facility based direct observation of treatment models on patients' satisfaction and TB treatment outcome in Nigeria.

PubMed

Adewole, Olanisun O; Oladele, T; Osunkoya, Arinola H; Erhabor, Greg E; Adewole, Temitayo O; Adeola, Oluwaseun; Obembe, Olufemi; Ota, Martin O C

2015-12-01

Directly observed treatment short-course (DOTS) strategy is an effective mode of treating TB. We aimed to study the cost effectiveness and patients' satisfaction with home based direct observation of treatment (DOT), an innovative approach to community-based DOT (CBDOT) and hospital based DOT (HBDOT). A randomized controlled trial involving 150 newly diagnosed pulmonary TB patients in four TB clinics in Ile Ife , Nigeria, was done. They were randomly assigned to receive treatment with anti TB drugs for the intensive phase administered at home by a TB worker (CBDOT) or at the hospital (HBDOT). Outcome measures were treatment completion/default rates, cost effectiveness and patients' satisfaction with care using a 13 item patients satisfaction questionnaire (PS-13) at 2 months. This trial was registered with pactr.org: number PACTR 201503001058381. At the end of intensive phase, 15/75 (20%) and 2/75 (3%) of patients in the HBDOT and CBDOT, respectively had defaulted from treatment, p= 0.01. Of those with pretreatment positive sputum smear, 97% (68/70) on CBDOT and 54/67 (81%) on HBDOT were sputum negative for AFB at the end of 2 months of treatment, p=0.01. The CBDOT method was associated with a higher patient satisfaction score compared with HBDOT (OR 3.1; 95% CI 1.25-7.70), p=0.001.The total cost for patients was higher in HBDOT (US$159.38) compared with the CBDOT (US$89.52). The incremental cost effectiveness ratio was US$410 per patient who completed the intensive phase treatment with CBDOT. CBDOT is a cost effective approach associated with better compliance to treatment and better patient satisfaction compared to HBDOT. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

S23. INTRODUCING COMPASS: COMPARING BRAIN ACTIVITY ACROSS PATIENTS WITH DIFFERENTIAL TREATMENT RESPONSE IN SCHIZOPHRENIA – AN OBSERVATIONAL STUDY

PubMed Central

Iglesias, Sandra; Siemerkus, Jakob; Bischof, Martin; Tomiello, Sara; Schöbi, Dario; Weber, Lilian; Heinzle, Jakob; Möller, Julian; Egger, Stephan; Gerke, Wolfgang; Baumgartner, Markus; Kawohl, Wolfram; Borgwardt, Stefan; Kaiser, Stefan; Haker, Helene; Stephan, Klaas Enno

2018-01-01

Abstract Background Present pharmacological treatment approaches in schizophrenia rest on “neuroleptic” drugs, all of which act as antagonists at dopamine D2/D3 receptors but additionally display major variability in their binding capacity to neurotransmitter receptors (Van Os & Kapur 2009). At present, the choice of any particular drug does not rest on any principled criteria: Once individual treatment has been started, therapeutic efficacy is monitored clinically, and a switch to a different drug is initiated when clear improvements remain absent after a few weeks. It is presently not possible to predict in advance which patients will respond well to a particular drug and who will experience little or no benefit (Case et al. 2011; Kapur et al. 2012). For instance, clozapine and olanzapine are often prescribed after other antipsychotics have shown to be ineffective in patients with schizophrenia or related disorders due to their pronounced side-effects. Both drugs, clozapine and olanzapine, share certain pharmacodynamic properties with comparatively low affinity towards dopamine D2-receptors, but very high affinity towards muscarinic receptors – a unique constellation that distinguishes them from other common antipsychotics. Importantly, previous studies have shown that a subgroup of schizophrenia patients might particularly benefit from these properties (Raedler et al. 2003, Scarr et al. 2009). Here, we present an ongoing observational study (COMPASS) which builds on these observations and addresses the question whether functional readouts of dopaminergic and muscarinic systems in individual patients could enable personalised treatment predictions. Guided by the dysconnection hypothesis of schizophrenia (Stephan et al., 2009), which postulates aberrant interactions between NMDA receptors and neuromodulators like dopamine/acetylcholine, the COMPASS study adopts a neuromodeling approach. The focus is on EEG/fMRI paradigms and computational models with

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

PubMed

von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

2014-12-01

Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparing different Ultraviolet Imaging Spectrograph (UVIS) occultation observations using modeling of water vapor jets

NASA Astrophysics Data System (ADS)

Portyankina, Ganna; Esposito, Larry W.; Hansen, Candice; Aye, Klaus-Michael

2016-10-01

Motivation: On March 11, 2016 the Cassini UVIS observed its 6th star occultation by Enceladus' plume. This observation was aimed to determine variability in the total gas flux from the Enceladus' southern polar region. The analysis of the received data suggests that the total gas flux is moderately increased comparing to the average gas flux observed by UVIS from 2005 to 2011 [1]. However, UVIS detected variability in individual jets. In particular, Baghdad 1 is more collimated in 2016 than in 2005, meaning its gas escapes at higher velocity.Model and fits: We use 3D DSMC model for water vapor jets to compare different UVIS occultation observations from 2005 to 2016. The model traces test articles from jets' sources [2] into space and results in coordinates and velocities for a set of test particles. We convert particle positions into the particle number density and integrate along UVIS line of sight (LoS) for each time step of the UVIS observation using precise observational geometry derived from SPICE [3]. We integrate all jets that are crossed by the LoS and perform constrained least-squares fit of resulting modeled opacities to the observed data to solved for relative strengths of jets. The geometry of each occultation is specific, for example, during solar occultation in 2010 UVIS LoS was almost parallel to tiger stripes, which made it possible to distinguish jets venting from different tiger stripes. In 2011 Eps Orionis occultation LoS was perpendicular to tiger stripes and thus many of the jets were geometrically overlapping. Solar occultation provided us with the largest inventory of active jets - our model fit detects at least 43 non-zero jet contributions. Stellar occultations generally have lower temporal resolution and observe only a sub-set of these jets: 2011 Eps Orionis needs minimum 25 non-zero jets to fit UVIS data. We will discuss different occultations and models fits, including the most recent Epsilon Orionis occultation of 2016.[1] Hansen et al

Use of acetaminophen and risk of endometrial cancer: evidence from observational studies.

PubMed

Ding, Yuan-Yuan; Yao, Peng; Verma, Surya; Han, Zhen-Kai; Hong, Tao; Zhu, Yong-Qiang; Li, Hong-Xi

2017-05-23

Previous meta-analyses suggested that aspirin was associated with reduced risk of endometrial cancer. However, there has been no study comprehensively summarize the evidence of acetaminophen use and risk of endometrial cancer from observational studies. We systematically searched electronic databases (PubMed , EMBASE, Web of Science, and Cochrane Library) for relevant cohort or case-control studies up to February 28, 2017. Two independent authors performed the eligibility evaluation and data extraction. All differences were resolved by discussion. A random-effects model was applied to estimate summary relative risks (RRs) with 95% CIs. All statistical tests were two-sided. Seven observational studies including four prospective cohort studies and three case-control studies with 3874 endometrial cancer cases were included for final analysis. Compared with never use acetaminophen, ever use this drug was not associated with risk of endometrial cancer (summarized RR = 1.02; 95% CI: 0.93-1.13, I2 = 0%). Similar null association was also observed when compared the highest category of frequency/duration with never use acetaminophen (summarized RR = 0.88; 95% CI: 0.70-1.11, I2 = 15.2%). Additionally, the finding was robust in the subgroup analyses stratified by study characteristics and adjustment for potential confounders and risk factors. There was no evidence of publication bias by a visual inspection of a funnel plot and formal statistical tests. In summary, the present meta-analysis reveals no association between acetaminophen use and risk of endometrial cancer. More large scale prospective cohort studies are warranted to confirm our findings and carry out the dose-response analysis of aforementioned association.

Plasmapause Location: Model Compared to Van Allen Probes Observations

NASA Astrophysics Data System (ADS)

Goldstein, J.; Baker, D. N.; Blake, J. B.; Funsten, H. O.; Jaynes, A. N.; Malaspina, D.; Reeves, G. D.; Spence, H. E.; Thaller, S. A.; Wygant, J. R.

2017-12-01

We study the evolution of the plasmapause for a multi-year period (January 2013 to January 2017) spanning much of the Van Allen Probes mission, by comparing the output of a plasmapause test particle simulation with the spacecraft potential measured by the Electric Field and Waves (EFW) suite. Consistent with previous results, we quantify the accuracy of the model by measuring the radial difference between real and virtual satellite encounters with the plasmapause boundary. We find that model performance is better on the nightside and during active periods, and worse on the duskside/dayside and during extended quiet intervals. For two case studies, we compare the plasmapause with the locations of relativistic electron flux peaks. For global context we use the test particle plasmaspheric index Fp [Goldstein et al., 2016], the fraction of a circular drift orbit inside the plasmapause, as a proxy for the globally integrated opportunity for losses in cold plasma. We find an inverse relationship between relativistic flux and the Fp index, consistent with increased likelihood of losses in cold plasma.

Reporting quality of statistical methods in surgical observational studies: protocol for systematic review.

PubMed

Wu, Robert; Glen, Peter; Ramsay, Tim; Martel, Guillaume

2014-06-28

Observational studies dominate the surgical literature. Statistical adjustment is an important strategy to account for confounders in observational studies. Research has shown that published articles are often poor in statistical quality, which may jeopardize their conclusions. The Statistical Analyses and Methods in the Published Literature (SAMPL) guidelines have been published to help establish standards for statistical reporting.This study will seek to determine whether the quality of statistical adjustment and the reporting of these methods are adequate in surgical observational studies. We hypothesize that incomplete reporting will be found in all surgical observational studies, and that the quality and reporting of these methods will be of lower quality in surgical journals when compared with medical journals. Finally, this work will seek to identify predictors of high-quality reporting. This work will examine the top five general surgical and medical journals, based on a 5-year impact factor (2007-2012). All observational studies investigating an intervention related to an essential component area of general surgery (defined by the American Board of Surgery), with an exposure, outcome, and comparator, will be included in this systematic review. Essential elements related to statistical reporting and quality were extracted from the SAMPL guidelines and include domains such as intent of analysis, primary analysis, multiple comparisons, numbers and descriptive statistics, association and correlation analyses, linear regression, logistic regression, Cox proportional hazard analysis, analysis of variance, survival analysis, propensity analysis, and independent and correlated analyses. Each article will be scored as a proportion based on fulfilling criteria in relevant analyses used in the study. A logistic regression model will be built to identify variables associated with high-quality reporting. A comparison will be made between the scores of surgical

Wind-Wave Effects on Vertical Mixing in Chesapeake Bay, USA: comparing observations to second-moment closure predictions.

NASA Astrophysics Data System (ADS)

Fisher, A. W.; Sanford, L. P.; Scully, M. E.

2016-12-01

Coherent wave-driven turbulence generated through wave breaking or nonlinear wave-current interactions, e.g. Langmuir turbulence (LT), can significantly enhance the downward transfer of momentum, kinetic energy, and dissolved gases in the oceanic surface layer. There are few observations of these processes in the estuarine or coastal environments, where wind-driven mixing may co-occur with energetic tidal mixing and strong density stratification. This presents a major challenge for evaluating vertical mixing parameterizations used in modeling estuarine and coastal dynamics. We carried out a large, multi-investigator study of wind-driven estuarine dynamics in the middle reaches of Chesapeake Bay, USA, during 2012-2013. The center of the observational array was an instrumented turbulence tower with both atmospheric and marine turbulence sensors as well as rapidly sampled temperature and conductivity sensors. For this paper, we examined the impacts of surface gravity waves on vertical profiles of turbulent mixing and compared our results to second-moment turbulence closure predictions. Wave and turbulence measurements collected from the vertical array of Acoustic Doppler Velocimeters (ADVs) provided direct estimates of the dominant terms in the TKE budget and the surface wave field. Observed dissipation rates, TKE levels, and turbulent length scales are compared to published scaling relations and used in the calculation of second-moment nonequilibrium stability functions. Results indicate that in the surface layer of the estuary, where elevated dissipation is balanced by vertical divergence in TKE flux, existing nonequilibrium stability functions underpredict observed eddy viscosities. The influences of wave breaking and coherent wave-driven turbulence on modeled and observed stability functions will be discussed further in the context of turbulent length scales, TKE and dissipation profiles, and the depth at which the wave-dominated turbulent transport layer

A systematic literature review on the efficacy–effectiveness gap: comparison of randomized controlled trials and observational studies of glucose-lowering drugs

PubMed Central

Ankarfeldt, Mikkel Z; Adalsteinsson, Erpur; Groenwold, Rolf HH; Ali, M Sanni; Klungel, Olaf H

2017-01-01

Aim To identify a potential efficacy–effectiveness gap and possible explanations (drivers of effectiveness) for differences between results of randomized controlled trials (RCTs) and observational studies investigating glucose-lowering drugs. Methods A systematic literature review was conducted in English language articles published between 1 January, 2000 and 31 January, 2015 describing either RCTs or observational studies comparing glucagon-like peptide-1 analogs (GLP-1) with insulin or comparing dipeptidyl peptidase-4 inhibitors (DPP-4i) with sulfonylurea, all with change in glycated hemoglobin (HbA1c) as outcome. Medline, Embase, Current Content, and Biosis were searched. Information on effect estimates, baseline characteristics of the study population, publication year, study duration, and number of patients, and for observational studies, characteristics related to confounding adjustment and selection- and information bias were extracted. Results From 312 hits, 11 RCTs and 7 observational studies comparing GLP-1 with insulin, and from 474 hits, 16 RCTs and 4 observational studies comparing DPP-4i with sulfonylurea were finally included. No differences were observed in baseline characteristics of the study populations (age, sex, body mass index, time since diagnosis of type 2 diabetes mellitus, and HbA1c) or effect sizes across study designs. Mean effect sizes ranged from −0.43 to 0.91 and from −0.80 to 1.13 in RCTs and observational studies, respectively, comparing GLP-1 with insulin, and from −0.13 to 2.70 and −0.20 to 0.30 in RCTs and observational studies, respectively, comparing DPP-4i and sulfonylurea. Generally, the identified observational studies held potential flaws with regard to confounding adjustment and selection- and information bias. Conclusions Neither potential drivers of effectiveness nor an efficacy–effectiveness gap were identified. However, the limited number of studies and potential problems with confounding adjustment

The reporting of observational research studies in dermatology journals: a literature-based study.

PubMed

Langan, Sinéad; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

2010-05-01

To assess the quality of reporting in observational studies in dermatology. Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta Dermato-Venereologica. Cohort, case-control, and cross-sectional studies published as original articles during the period January 2005 through December 2007. Studies were identified with a literature search of PubMed combining the journal title and the term epidemiological studies (free text) and by hand searching all of the issues of each journal to identify relevant articles. All articles were extracted by 2 reviewers independently using standardized checklists based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. The number and proportion of reported STROBE items were analyzed for each article. The proportion of studies with good reporting for each item was also assessed. A total of 138 articles were included and analyzed. Reporting quality was very mixed. Key areas that were infrequently reported included sample size calculations (n = 10 [7%]), missing data (n = 8 [6%]), losses to follow-up (n = 17 [12%]), and statistical methods (n = 19 [14%]). Only 13 studies (9%) explained the role of funders in the research. The quality of reporting was similar across study designs for "critical" questions with the exception of reporting of participant details, which was better reported in cohort studies (96%) compared with cross-sectional (80%) and case-control (70%) studies. It is difficult to judge the quality of dermatological research unless it is reported well. This study has identified a clear need to improve the quality of reporting of observational studies in dermatology. We recommend that dermatology journals adopt the STROBE criteria.

Ion cyclotron instability at Io: Hybrid simulation results compared to in situ observations

NASA Astrophysics Data System (ADS)

Šebek, Ondřej; Trávníček, Pavel M.; Walker, Raymond J.; Hellinger, Petr

2016-08-01

We present analysis of global three-dimensional hybrid simulations of Io's interaction with Jovian magnetospheric plasma. We apply a single-species model with simplified neutral-plasma chemistry and downscale Io in order to resolve the ion kinetic scales. We consider charge exchange, electron impact ionization, and photoionization by using variable rates of these processes to investigate their impact. Our results are in a good qualitative agreement with the in situ magnetic field measurements for five Galileo flybys around Io. The hybrid model describes ion kinetics self-consistently. This allows us to assess the distribution of temperature anisotropies around Io and thereby determine the possible triggering mechanism for waves observed near Io. We compare simulated dynamic spectra of magnetic fluctuations with in situ observations made by Galileo. Our results are consistent with both the spatial distribution and local amplitude of magnetic fluctuations found in the observations. Cyclotron waves, triggered probably by the growth of ion cyclotron instability, are observed mainly downstream of Io and on the flanks in regions farther from Io where the ion pickup rate is relatively low. Growth of the ion cyclotron instability is governed mainly by the charge exchange rate.

Insulin pump use compared with intravenous insulin during labour and delivery: the INSPIRED observational cohort study.

PubMed

Drever, E; Tomlinson, G; Bai, A D; Feig, D S

2016-09-01

To assess the safety and efficacy of pump therapy (continuous subcutaneous insulin infusion; CSII) during labour and delivery in women with Type 1 diabetes. A retrospective cohort study of 161 consecutive Type 1 diabetic pregnancies delivered during 2000-2010 at Mount Sinai Hospital, Toronto, Canada. Capillary blood glucose levels during labour and delivery and time in/out of target (target: 4-6 mmol/l) were compared along with neonatal outcomes for three groups: (1) women on pumps who stayed on pumps during labour (pump/pump n = 31), (2) women on pumps who switched to intravenous (IV) insulin infusion during labour (pump/IVn = 25), and (3) women on multiple daily injections who switched to IV insulin infusion during labour (MDIn = 105). There were no significant differences between the mean or median glucose values during labour and delivery across all three groups, and no significant difference in time spent hypoglycaemic. However, women in the pump/pump group had significantly better glycaemic control as defined by mean glucose (5.5 vs. 6.4 mmol/l; P = 0.01), median glucose (5.4 vs. 6.3 mmol/l; P = 0.02), and more time spent in target (60.9% vs. 39.2%; P = 0.06) compared with women in the pump/IV group (after removing one outlier). This study demonstrates that the continuation of CSII therapy during labour and delivery appears safe and efficacious. Moreover, women who choose to continue CSII have better glucose control during delivery than those who switch to IV insulin, suggesting that it should be standard practice to allow women the option of continuing CSII during labour and delivery. © 2016 Diabetes UK.

The FluxCompensator: Making Radiative Transfer Models of Hydrodynamical Simulations Directly Comparable to Real Observations

NASA Astrophysics Data System (ADS)

Koepferl, Christine M.; Robitaille, Thomas P.

2017-11-01

When modeling astronomical objects throughout the universe, it is important to correctly treat the limitations of the data, for instance finite resolution and sensitivity. In order to simulate these effects, and to make radiative transfer models directly comparable to real observations, we have developed an open-source Python package called the FluxCompensator that enables the post-processing of the output of 3D Monte Carlo radiative transfer codes, such as Hyperion. With the FluxCompensator, realistic synthetic observations can be generated by modeling the effects of convolution with arbitrary point-spread functions, transmission curves, finite pixel resolution, noise, and reddening. Pipelines can be applied to compute synthetic observations that simulate observatories, such as the Spitzer Space Telescope or the Herschel Space Observatory. Additionally, this tool can read in existing observations (e.g., FITS format) and use the same settings for the synthetic observations. In this paper, we describe the package as well as present examples of such synthetic observations.

The FluxCompensator: Making Radiative Transfer Models of Hydrodynamical Simulations Directly Comparable to Real Observations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koepferl, Christine M.; Robitaille, Thomas P., E-mail: koepferl@usm.lmu.de

When modeling astronomical objects throughout the universe, it is important to correctly treat the limitations of the data, for instance finite resolution and sensitivity. In order to simulate these effects, and to make radiative transfer models directly comparable to real observations, we have developed an open-source Python package called the FluxCompensator that enables the post-processing of the output of 3D Monte Carlo radiative transfer codes, such as Hyperion. With the FluxCompensator, realistic synthetic observations can be generated by modeling the effects of convolution with arbitrary point-spread functions, transmission curves, finite pixel resolution, noise, and reddening. Pipelines can be applied tomore » compute synthetic observations that simulate observatories, such as the Spitzer Space Telescope or the Herschel Space Observatory . Additionally, this tool can read in existing observations (e.g., FITS format) and use the same settings for the synthetic observations. In this paper, we describe the package as well as present examples of such synthetic observations.« less

Randomized controlled trials vs. observational studies: why not just live together?

PubMed

Faraoni, David; Schaefer, Simon Thomas

2016-10-21

Randomized controlled trials (RCTs) are considered the gold standard for clinical research, thus having a high impact on clinical guidelines and our daily patients' care. However, various treatment strategies which we consider "evidence based" have never been subject to a prospective RCT, as we would rate it unethical to withheld an established treatment to individuals in an placebo controlled trial.In a recent BMC Anesthesiology publication, Trentino et al. analyzed the usefulness of observational studies in assessing benefit and risk of different transfusion strategies. The authors nicely reviewed and summarized similarities and differences, advantages and limitations, between different study types frequently used in transfusion medicine. In this interesting article, the authors conclude, that 'when comparing the results of observational studies with RCTs assessing transfusion outcomes, it is important that one consider not only the study method, but also the key elements of the study design'. Thus, in this commentary we now discuss the pro's and con's of different study types, even irrespective of transfusion medicine.

ADAPTIVE MATCHING IN RANDOMIZED TRIALS AND OBSERVATIONAL STUDIES

PubMed Central

van der Laan, Mark J.; Balzer, Laura B.; Petersen, Maya L.

2014-01-01

SUMMARY In many randomized and observational studies the allocation of treatment among a sample of n independent and identically distributed units is a function of the covariates of all sampled units. As a result, the treatment labels among the units are possibly dependent, complicating estimation and posing challenges for statistical inference. For example, cluster randomized trials frequently sample communities from some target population, construct matched pairs of communities from those included in the sample based on some metric of similarity in baseline community characteristics, and then randomly allocate a treatment and a control intervention within each matched pair. In this case, the observed data can neither be represented as the realization of n independent random variables, nor, contrary to current practice, as the realization of n/2 independent random variables (treating the matched pair as the independent sampling unit). In this paper we study estimation of the average causal effect of a treatment under experimental designs in which treatment allocation potentially depends on the pre-intervention covariates of all units included in the sample. We define efficient targeted minimum loss based estimators for this general design, present a theorem that establishes the desired asymptotic normality of these estimators and allows for asymptotically valid statistical inference, and discuss implementation of these estimators. We further investigate the relative asymptotic efficiency of this design compared with a design in which unit-specific treatment assignment depends only on the units’ covariates. Our findings have practical implications for the optimal design and analysis of pair matched cluster randomized trials, as well as for observational studies in which treatment decisions may depend on characteristics of the entire sample. PMID:25097298

Testing Collisional Scaling Laws: Comparing with Observables

NASA Astrophysics Data System (ADS)

Davis, D. R.; Marzari, F.; Farinella, P.

1999-09-01

How large bodies break up in response to energetic collisions is a problem that has attracted considerable attention in recent years. Ever more sophisticated computation methods have also been developed; prominent among these are hydrocode simulations of collisional disruption by Benz and Asphaug (1999, Icarus, in press), Love and Ahrens (1996, LPSC XXVII, 777-778), and Melosh and Ryan (1997, Icarus 129, 562-564). Durda et al. (1998, Icarus 135, 431-440) used the observed asteroid size distribution to infer a scaling algorithm. The present situation is that there are several proposed scaling laws that differ by as much as two orders of magnitude at particular sizes. We have expanded upon the work of Davis et al. (1994, Goutelas Proceedings) and tested the suite of proposed scaling algorithms against observations of the main-belt asteroids. The effects of collisions among the asteroids produce the following observables: (a) the size distribution has been significantly shaped by collisions, (b) collisions have produced about 25 well recognized asteroid families, and (c) the basaltic crust of Vesta has been largely preserved in the face of about 4.5 Byr of impacts. We will present results from a numerical simulation of asteroid collisional evolution over the age of the solar system using proposed scaling laws and a range of hypothetical initial populations.

Standards and guidelines for observational studies: quality is in the eye of the beholder.

PubMed

Morton, Sally C; Costlow, Monica R; Graff, Jennifer S; Dubois, Robert W

2016-03-01

Patient care decisions demand high-quality research. To assist those decisions, numerous observational studies are being performed. Are the standards and guidelines to assess observational studies consistent and actionable? What policy considerations should be considered to ensure decision makers can determine if an observational study is of high-quality and valid to inform treatment decisions? Based on a literature review and input from six experts, we compared and contrasted nine standards/guidelines using 23 methodological elements involved in observational studies (e.g., study protocol, data analysis, and so forth). Fourteen elements (61%) were addressed by at least seven standards/guidelines; 12 of these elements disagreed in the approach. Nine elements (39%) were addressed by six or fewer standards/guidelines. Ten elements (43%) were not actionable in at least one standard/guideline that addressed the element. The lack of observational study standard/guideline agreement may contribute to variation in study conduct; disparities in what is considered credible research; and ultimately, what evidence is adopted. A common set of agreed on standards/guidelines for conducting observational studies will benefit funders, researchers, journal editors, and decision makers. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

A comparative study of mixture cure models with covariate

NASA Astrophysics Data System (ADS)

Leng, Oh Yit; Khalid, Zarina Mohd

2017-05-01

In survival analysis, the survival time is assumed to follow a non-negative distribution, such as the exponential, Weibull, and log-normal distributions. In some cases, the survival time is influenced by some observed factors. The absence of these observed factors may cause an inaccurate estimation in the survival function. Therefore, a survival model which incorporates the influences of observed factors is more appropriate to be used in such cases. These observed factors are included in the survival model as covariates. Besides that, there are cases where a group of individuals who are cured, that is, not experiencing the event of interest. Ignoring the cure fraction may lead to overestimate in estimating the survival function. Thus, a mixture cure model is more suitable to be employed in modelling survival data with the presence of a cure fraction. In this study, three mixture cure survival models are used to analyse survival data with a covariate and a cure fraction. The first model includes covariate in the parameterization of the susceptible individuals survival function, the second model allows the cure fraction to depend on covariate, and the third model incorporates covariate in both cure fraction and survival function of susceptible individuals. This study aims to compare the performance of these models via a simulation approach. Therefore, in this study, survival data with varying sample sizes and cure fractions are simulated and the survival time is assumed to follow the Weibull distribution. The simulated data are then modelled using the three mixture cure survival models. The results show that the three mixture cure models are more appropriate to be used in modelling survival data with the presence of cure fraction and an observed factor.

Comparing the statistics of interstellar turbulence in simulations and observations. Solenoidal versus compressive turbulence forcing

NASA Astrophysics Data System (ADS)

Federrath, C.; Roman-Duval, J.; Klessen, R. S.; Schmidt, W.; Mac Low, M.-M.

2010-03-01

Context. Density and velocity fluctuations on virtually all scales observed with modern telescopes show that molecular clouds (MCs) are turbulent. The forcing and structural characteristics of this turbulence are, however, still poorly understood. Aims: To shed light on this subject, we study two limiting cases of turbulence forcing in numerical experiments: solenoidal (divergence-free) forcing and compressive (curl-free) forcing, and compare our results to observations. Methods: We solve the equations of hydrodynamics on grids with up to 10243 cells for purely solenoidal and purely compressive forcing. Eleven lower-resolution models with different forcing mixtures are also analysed. Results: Using Fourier spectra and Δ-variance, we find velocity dispersion-size relations consistent with observations and independent numerical simulations, irrespective of the type of forcing. However, compressive forcing yields stronger compression at the same rms Mach number than solenoidal forcing, resulting in a three times larger standard deviation of volumetric and column density probability distributions (PDFs). We compare our results to different characterisations of several observed regions, and find evidence of different forcing functions. Column density PDFs in the Perseus MC suggest the presence of a mainly compressive forcing agent within a shell, driven by a massive star. Although the PDFs are close to log-normal, they have non-Gaussian skewness and kurtosis caused by intermittency. Centroid velocity increments measured in the Polaris Flare on intermediate scales agree with solenoidal forcing on that scale. However, Δ-variance analysis of the column density in the Polaris Flare suggests that turbulence is driven on large scales, with a significant compressive component on the forcing scale. This indicates that, although likely driven with mostly compressive modes on large scales, turbulence can behave like solenoidal turbulence on smaller scales. Principal component

AMR Studies of Star Formation: Simulations and Simulated Observations

NASA Astrophysics Data System (ADS)

Offner, Stella; McKee, C. F.; Klein, R. I.

2009-01-01

Molecular clouds are typically observed to be approximately virialized with gravitational and turbulent energy in balance, yielding a star formation rate of a few percent. The origin and characteristics of the observed supersonic turbulence are poorly understood, and without continued energy injection the turbulence is predicted to decay within a cloud dynamical time. Recent observations and analytic work have suggested a strong connection between the initial stellar mass function, the core mass function, and turbulence characteristics. The role of magnetic fields in determining core lifetimes, shapes, and kinematic properties remains hotly debated. Simulations are a formidable tool for studying the complex process of star formation and addressing these puzzles. I present my results modeling low-mass star formation using the ORION adaptive mesh refinement (AMR) code. I investigate the properties of forming cores and protostars in simulations in which the turbulence is driven to maintain virial balance and where it is allowed to decay. I will discuss simulated observations of cores in dust emission and in molecular tracers and compare to observations of local star-forming clouds. I will also present results from ORION cluster simulations including flux-limited diffusion radiative transfer and show that radiative feedback, even from low-mass stars, has a significant effect on core fragmentation, disk properties, and the IMF. Finally, I will discuss the new simulation frontier of AMR multigroup radiative transfer.

Cultivating cohort studies for observational translational research.

PubMed

Ransohoff, David F

2013-04-01

"Discovery" research about molecular markers for diagnosis, prognosis, or prediction of response to therapy has frequently produced results that were not reproducible in subsequent studies. What are the reasons, and can observational cohorts be cultivated to provide strong and reliable answers to those questions? Experimental Selected examples are used to illustrate: (i) what features of research design provide strength and reliability in observational studies about markers of diagnosis, prognosis, and response to therapy? (ii) How can those design features be cultivated in existing observational cohorts, for example, within randomized controlled clinical trial (RCT), other existing observational research studies, or practice settings like health maintenance organization (HMOs)? Examples include a study of RNA expression profiles of tumor tissue to predict prognosis of breast cancer, a study of serum proteomics profiles to diagnose ovarian cancer, and a study of stool-based DNA assays to screen for colon cancer. Strengths and weaknesses of observational study design features are discussed, along with lessons about how features that help assure strength might be "cultivated" in the future. By considering these examples and others, it may be possible to develop a process of "cultivating cohorts" in ongoing RCTs, observational cohort studies, and practice settings like HMOs that have strong features of study design. Such an effort could produce sources of data and specimens to reliably answer questions about the use of molecular markers in diagnosis, prognosis, and response to therapy.

A Comparative Observational Study of YSO Classification in Four Small Star-forming H ii Regions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, Sung-Ju; Choi, Minho; Kang, Miju

We have developed a new young stellar object (YSO) identification and classification technique using mid-infrared Wide-field Infrared Survey Explorer (WISE) data. We compare this new technique with previous WISE YSO detection and classification methods that used either infrared colors or spectral energy distribution slopes. In this study, we also use the new technique to detect and examine the YSO population associated with four small H ii regions: KR 7, KR 81, KR 120, and KR 140. The relatively simple structure of these regions allows us to effectively use both spatial and temporal constraints to identify YSOs that are potential productsmore » of triggered star formation. We are also able to identify regions of active star formation around these H ii regions that are clearly not influenced by the H ii region expansion, and thus demonstrate that star formation is on-going on megayear timescales in some of these molecular clouds.« less

Comparative study of volatile organic compounds in ambient air using observed mixing ratios and initial mixing ratios taking chemical loss into account - A case study in a typical urban area in Beijing.

PubMed

Gao, Jian; Zhang, Jie; Li, Hong; Li, Lei; Xu, Linghong; Zhang, Yujie; Wang, Zhanshan; Wang, Xuezhong; Zhang, Weiqi; Chen, Yizhen; Cheng, Xi; Zhang, Hao; Peng, Liang; Chai, Fahe; Wei, Yongjie

2018-07-01

Volatile organic compounds (VOCs) can react with atmospheric radicals while being transported after being emitted, resulting in substantial losses. Using only observed VOC mixing ratios to assess VOC pollution, is therefore problematic. The observed mixing ratios and initial mixing ratios taking chemical loss into consideration were performed using data for 90 VOCs in the atmosphere in a typical urban area in Beijing in winter 2013 to gain a more accurate view of VOC pollution. The VOC sources, ambient VOC mixing ratios and compositions, variability and influencing factors, contributions to near-ground-ozone and health risks posed were assessed. Source apportionment should be conducted using initial mixing ratios, but health risks should be assessed using observed mixing ratios. The daytime daily mean initial mixing ratio (72.62ppbv) was 7.72ppbv higher than the daytime daily mean observed mixing ratio (64.90ppbv). Alkenes contributed >70% of the consumed VOCs. The nighttime daily mean observed mixing ratio was 71.66ppbv, 6.76ppbv higher than the daytime mixing ratio. The observed mixing ratio for 66 VOCs was 40.31% higher in Beijing than New York. The OFPs of Ini-D (266.54ppbv) was underestimated 23.41% compared to the OFP of Obs-D (204.14ppbv), improving emission control of ethylene and propene would be an effective way of controlling O 3 . Health risk assessments performed for 28 hazardous VOCs show that benzene, chloroform, 1,2-dichloroethane, and acetaldehyde pose carcinogenic risk and acrolein poses non-carcinogenic risks. Source apportionment results indicated that vehicle exhausts, solvent usage and industrial processes were the main VOC source during the study. Copyright © 2018. Published by Elsevier B.V.

Intrauterine temperature during intrapartum amnioinfusion: a prospective observational study.

PubMed

Tomlinson, T M; Schaecher, C; Sadovsky, Y; Gross, G

2012-07-01

To determine the influence of routine intrapartum amnioinfusion (AI) on intrauterine temperature. Prospective observational study. Maternity unit, Barnes Jewish Hospital, St Louis, MO, USA. Forty women with singleton gestations and an indication for intrapartum intrauterine pressure catheter placement. Using a temperature probe, we digitally recorded intrauterine temperature every 10 minutes during labour. Amnioinfusion was administered according to a standard protocol using saline equilibrated to the ambient temperature. Mean intrauterine temperature during labour. Participants were monitored for a mean of 280 minutes (range 20-820). A total of 164 intrauterine temperature readings in the AI cohort were compared with 797 control measurements. When compared with controls, we observed a lower intrauterine temperature in the AI cohort (36.4 versus 37.4°C, P<0.01). More measurements in the AI cohort were recorded in the presence of intrapartum fever (40% versus 30%). A subgroup analysis of measurements recorded in afebrile parturients revealed an even greater effect of AI (1.5°C decrease, 37.3 versus 35.8°C, P<0.01). Routine intrapartum AI using saline equilibrated to a mean ambient temperature of 25.0°C reduces intrauterine temperature and may thereby affect fetal core temperature. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Aerosols optical properties in dynamic atmosphere in the northwestern part of the Indian Himalaya: A comparative study from ground and satellite based observations

NASA Astrophysics Data System (ADS)

Guleria, Raj Paul; Kuniyal, Jagdish Chandra; Rawat, Pan Singh; Thakur, Harinder Kumar; Sharma, Manum; Sharma, Nand Lal; Singh, Mahavir; Chand, Kesar; Sharma, Priyanka; Thakur, Ajay Kumar; Dhyani, Pitamber Prasad; Bhuyan, Pradip Kumar

2011-08-01

The present study deals with the aerosol optical property which carried out during April 2006 to March 2007 over Mohal (31.9°N, 77.12°E) in the northwestern Indian Himalaya. The study was conducted using ground based Multi-wavelength Radiometer (MWR) and Moderate Resolution Imaging Spectroradiometer (MODIS) sensor. The daily average aerosol optical depth (AOD) at 500 nm was found to be (mean ± standard deviation) 0.24 ± 0.10. The afternoon AOD values have been noticed to be higher than the forenoon AOD values. Spectral AOD values exhibited larger day-to-day variation in finer aerosols during the observation period. The daily average value of Ångström exponent 'α' and turbidity coefficient 'β' obtained was 1.10 ± 0.38 and 0.12 ± 0.08 respectively. Higher value of AOD ~ 0.39 ± 0.06 during summer associated with low α ~ 0.73 ± 0.28 has attributed to the increase in the relative dominance of coarse size particles. In winter α ~ 1.21 ± 0.32 indicating a considerable increase in fine size particles, attributed to the anthropogenic activities. The AOD spectra seem to be more wavelength dependent in winter as compared to summer. Comparison of MWR observation with MODIS observation indicates a good conformity between ground-based and satellite derived AOD. The root mean square deviation (RMSD), mean absolute bias deviation (MABD) and correlation coefficient have been found to be ~ 0.08, ~ 0.06 and ~ 0.77 respectively. These results suggest that the AOD retrieval through satellite can be able to characterize AOD distribution over Mohal. However, further efforts to eliminate systematic errors in the existing MODIS products are needed. During the observation period ~ 30%, ~ 47% and ~ 62% air parcels drawn at 4000, 5500 and 8000 m above ground level respectively reached at Mohal which passed through or originated from The Great Sahara. The maximum AOD at 500 nm occurred on 8 May 2006. This has caused a significant reduction in surface reaching solar irradiance by

Comparative cytogenetic and cytologic study in malignant lymphomas.

PubMed

Răileanu-Motoiu, I; Gociu, M; Leahu, S; Berceanu, S

1976-01-01

The possibility of a cytogenetic-cytologic correlation with implications in the diagnosis, evolutivity and prognosis of malignant lymphomas was studied. Cytogenetic investigations were carried out comparatively in the lymph node and spleen lymphoid cells from 25 patients with malignant lymphomas and in normal subjects or patients with malignant tumors. The dominant malignant cellular type was found to correspond genotypically to the abnormal clone. In lymphomas with more differentiated cells the chormosomal abnormalities were limited to a single chromosomal group, while in those with less differentiated cells there were many clonal chromozomal abnormalities. The pathogenic significance of an extra-chromosome in the C-group (observed in most of the cases) is discussed.

Comparative studies of industrial grade carbon black powders

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chawla, Komal, E-mail: komalchawla.rs@gmail.com; Chauhan, Alok P. S., E-mail: chauhan.alok@gmail.com, E-mail: alok.chauhan@alumni.stonybrook.edu

Comparative studies of two dissimilar industrial grade Carbon Black (CB) powders (N375 and N405) were conducted. The structure, surface area and particle size are the three important characteristics of CB powder that determine their processability and application as filler in preparing rubber compounds. The powders were characterized for their structure using dibutyl phthalate absorption (DBPA), particle size via laser particle size analyzer and surface area by nitrogen adsorption method. The structural characterization showed that N405 had lower DBPA in comparison to N375, confirming low structure of N405 grade CB powder. It was observed from the particle size analysis that N375more » was coarser than N405 grade CB. The total surface area values were determined by the BET method based on the cross sectional area of the nitrogen molecule. N375, a coarse grade CB powder with high structure, depicted less surface area as compared to N405.« less

Benchmarking Controlled Trial--a novel concept covering all observational effectiveness studies.

PubMed

Malmivaara, Antti

2015-06-01

The Benchmarking Controlled Trial (BCT) is a novel concept which covers all observational studies aiming to assess effectiveness. BCTs provide evidence of the comparative effectiveness between health service providers, and of effectiveness due to particular features of the health and social care systems. BCTs complement randomized controlled trials (RCTs) as the sources of evidence on effectiveness. This paper presents a definition of the BCT; compares the position of BCTs in assessing effectiveness with that of RCTs; presents a checklist for assessing methodological validity of a BCT; and pilot-tests the checklist with BCTs published recently in the leading medical journals.

Benchmarking Controlled Trial—a novel concept covering all observational effectiveness studies

PubMed Central

Malmivaara, Antti

2015-01-01

Abstract The Benchmarking Controlled Trial (BCT) is a novel concept which covers all observational studies aiming to assess effectiveness. BCTs provide evidence of the comparative effectiveness between health service providers, and of effectiveness due to particular features of the health and social care systems. BCTs complement randomized controlled trials (RCTs) as the sources of evidence on effectiveness. This paper presents a definition of the BCT; compares the position of BCTs in assessing effectiveness with that of RCTs; presents a checklist for assessing methodological validity of a BCT; and pilot-tests the checklist with BCTs published recently in the leading medical journals. PMID:25965700

A Pilot Study Comparing Observational and Questionnaire Surrogate Measures of Pesticide Exposure Among Residents Impacted by the Ecuadorian Flower Industry.

PubMed

Handal, Alexis J; McGough-Maduena, Alison; Páez, Maritza; Skipper, Betty; Rowland, Andrew S; Fenske, Richard A; Harlow, Siobán D

2015-01-01

Self-reported measures of residential pesticide exposure are commonly used in epidemiological studies, especially when financial and logistical resources are limited. However, self-reporting is prone to misclassification bias. This pilot study assesses the agreement between self-report of residential pesticide exposure with direct observation measures, in an agricultural region of Ecuador, as a cross-validation method in 26 participants (16 rose workers and 10 controls), with percent agreement and kappa statistics calculated. Proximity of homes to nearby flower farms was found to have only fair agreement (kappa =.35). The use of discarded plastics (kappa =.06) and wood (kappa =.13) were found to have little agreement. Results indicate that direct observation or measurement may provide more accurate appraisals of residential exposures, such as proximity to industrial farmland and the use of discarded materials obtained from the flower farms.

Medication safety research by observational study design.

PubMed

Lao, Kim S J; Chui, Celine S L; Man, Kenneth K C; Lau, Wallis C Y; Chan, Esther W; Wong, Ian C K

2016-06-01

Observational studies have been recognised to be essential for investigating the safety profile of medications. Numerous observational studies have been conducted on the platform of large population databases, which provide adequate sample size and follow-up length to detect infrequent and/or delayed clinical outcomes. Cohort and case-control are well-accepted traditional methodologies for hypothesis testing, while within-individual study designs are developing and evolving, addressing previous known methodological limitations to reduce confounding and bias. Respective examples of observational studies of different study designs using medical databases are shown. Methodology characteristics, study assumptions, strengths and weaknesses of each method are discussed in this review.

Creating a Common Data Model for Comparative Effectiveness with the Observational Medical Outcomes Partnership.

PubMed

FitzHenry, F; Resnic, F S; Robbins, S L; Denton, J; Nookala, L; Meeker, D; Ohno-Machado, L; Matheny, M E

2015-01-01

Adoption of a common data model across health systems is a key infrastructure requirement to allow large scale distributed comparative effectiveness analyses. There are a growing number of common data models (CDM), such as Mini-Sentinel, and the Observational Medical Outcomes Partnership (OMOP) CDMs. In this case study, we describe the challenges and opportunities of a study specific use of the OMOP CDM by two health systems and describe three comparative effectiveness use cases developed from the CDM. The project transformed two health system databases (using crosswalks provided) into the OMOP CDM. Cohorts were developed from the transformed CDMs for three comparative effectiveness use case examples. Administrative/billing, demographic, order history, medication, and laboratory were included in the CDM transformation and cohort development rules. Record counts per person month are presented for the eligible cohorts, highlighting differences between the civilian and federal datasets, e.g. the federal data set had more outpatient visits per person month (6.44 vs. 2.05 per person month). The count of medications per person month reflected the fact that one system's medications were extracted from orders while the other system had pharmacy fills and medication administration records. The federal system also had a higher prevalence of the conditions in all three use cases. Both systems required manual coding of some types of data to convert to the CDM. The data transformation to the CDM was time consuming and resources required were substantial, beyond requirements for collecting native source data. The need to manually code subsets of data limited the conversion. However, once the native data was converted to the CDM, both systems were then able to use the same queries to identify cohorts. Thus, the CDM minimized the effort to develop cohorts and analyze the results across the sites.

Prepubertal and postpubertal vitiligo: a multivariate comparative study in 375 patients*

PubMed Central

Khurrum, Huma; AlGhamdi, Khalid M

2017-01-01

Background The onset of vitiligo during childhood is common. Limited data exist that compare the clinical associations of prepubertal and postpubertal vitiligo in Arabs. Objective To compare the clinical profile of pre and postpubertal onset vitiligo. Methods A cross-sectional observational study was conducted. The Vitiligo European Task Force questionnaire was completed for each patient. Results A total of 375 patients were included; 199 had postpubertal vitiligo (>12 years), and 176 had prepubertal onset vitiligo (<12years). There were more females in the prepubertal group (49%) than in the postpubertal group (29%), p-value <0.001. The prepubertal group has had more involvement than the postpubertal group (45% vs 30%, p=0.004). Only 8 cases of segmental vitiligo were observed; five were observed in the prepubertal group of patients. Female gender (OR=2.3; 95% CI:1.5, 3.5), presence of halo nevus (OR=2.2; 95% CI:1.1, 4.4) and face involvement (OR=1.9; 95% CI:1.2, 2.9) were positively associated with prepubertal vitiligo. Stress, as an onset factor, was positively associated (OR=0.51; 95% CI:0.3, 0.8) with postpubertal onset vitiligo. Study limitations A possible selection bias toward more severe vitiligo cases can be a limitation, because the study was conducted in a clinic specialized in vitiligo. Moreover, a likelihood of false recall bias cannot be excluded. Conclusions Our data present clinical evidence that vitiligo behaves mostly the same way in the prepubertal group as in the postpubertal group. However, female over-representation, more face involvement and more halo nevi were observed in prepubertal vitiligo, while stress was more prevalent as an aggravating factor in postpubertal vitiligo patients. PMID:29364437

Drivers' phone use at red traffic lights: a roadside observation study comparing calls and visual-manual interactions.

PubMed

Huth, Véronique; Sanchez, Yann; Brusque, Corinne

2015-01-01

Phone use while driving has become one of the priority issues in road safety, given that it may lead to decreased situation awareness and deteriorated driving performance. It has been suggested that drivers can regulate their exposure to secondary tasks and seek for compatibility of phone use and driving. Phone use strategies include the choice of driving situations with low demands and interruptions of the interaction when the context changes. Traffic light situations at urban intersections imply both a temptation to use the phone while waiting at the red traffic light and a potential threat due to the incompatibility of phone use and driving when the traffic light turns green. These two situations were targeted in a roadside observation study, with the aim to investigate the existence of a phone use strategy at the red traffic light and to test its effectiveness. N=124 phone users and a corresponding control group of non-users were observed. Strategic phone use behaviour was detected for visual-manual interactions, which are more likely to be initiated at the red traffic light and tend to be stopped before the vehicle moves off, while calls are less likely to be limited to the red traffic light situation. As an indicator of impaired situation awareness, delayed start was associated to phone use and in particular to visual-manual interactions, whether phone use was interrupted before moving off or not. Traffic light situations do not seem to allow effective application of phone use strategies, although drivers attempt to do so for the most demanding phone use mode. The underlying factors of phone use need to be studied so as to reduce the temptation of phone use and facilitate exposure regulation strategies. Copyright © 2014. Published by Elsevier Ltd.

The Alberta smoke plume observation study

NASA Astrophysics Data System (ADS)

Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

2018-02-01

A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at http://cwfis.cfs.nrcan.gc.ca/datamart.

Video techniques and data compared with observation in emergency trauma care

PubMed Central

Mackenzie, C; Xiao, Y

2003-01-01

Video recording is underused in improving patient safety and understanding performance shaping factors in patient care. We report our experience of using video recording techniques in a trauma centre, including how to gain cooperation of clinicians for video recording of their workplace performance, identify strengths of video compared with observation, and suggest processes for consent and maintenance of confidentiality of video records. Video records are a rich source of data for documenting clinician performance which reveal safety and systems issues not identified by observation. Emergency procedures and video records of critical events identified patient safety, clinical, quality assurance, systems failures, and ergonomic issues. Video recording is a powerful feedback and training tool and provides a reusable record of events that can be repeatedly reviewed and used as research data. It allows expanded analyses of time critical events, trauma resuscitation, anaesthesia, and surgical tasks. To overcome some of the key obstacles in deploying video recording techniques, researchers should (1) develop trust with video recorded subjects, (2) obtain clinician participation for introduction of a new protocol or line of investigation, (3) report aggregated video recorded data and use clinician reviews for feedback on covert processes and cognitive analyses, and (4) involve multidisciplinary experts in medicine and nursing. PMID:14645896

Effects of pointing compared with naming and observing during encoding on item and source memory in young and older adults.

PubMed

Ouwehand, Kim; van Gog, Tamara; Paas, Fred

2016-10-01

Research showed that source memory functioning declines with ageing. Evidence suggests that encoding visual stimuli with manual pointing in addition to visual observation can have a positive effect on spatial memory compared with visual observation only. The present study investigated whether pointing at picture locations during encoding would lead to better spatial source memory than naming (Experiment 1) and visual observation only (Experiment 2) in young and older adults. Experiment 3 investigated whether response modality during the test phase would influence spatial source memory performance. Experiments 1 and 2 supported the hypothesis that pointing during encoding led to better source memory for picture locations than naming or observation only. Young adults outperformed older adults on the source memory but not the item memory task in both Experiments 1 and 2. In Experiments 1 and 2, participants manually responded in the test phase. Experiment 3 showed that if participants had to verbally respond in the test phase, the positive effect of pointing compared with naming during encoding disappeared. The results suggest that pointing at picture locations during encoding can enhance spatial source memory in both young and older adults, but only if the response modality is congruent in the test phase.

Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity.

PubMed

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M Teresa; Losada, José L; Portell, Mariona; Lozano-Lozano, José A

2018-01-01

Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity

PubMed Central

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M. Teresa; Losada, José L.; Portell, Mariona; Lozano-Lozano, José A.

2018-01-01

Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

Measuring Medical Housestaff Teamwork Performance Using Multiple Direct Observation Instruments: Comparing Apples and Apples.

PubMed

Weingart, Saul N; Yaghi, Omar; Wetherell, Matthew; Sweeney, Megan

2018-04-10

To examine the composition and concordance of existing instruments used to assess medical teams' performance. A trained observer joined 20 internal medicine housestaff teams for morning work rounds at Tufts Medical Center, a 415-bed Boston teaching hospital, from October through December 2015. The observer rated each team's performance using 9 teamwork observation instruments that examined domains including team structure, leadership, situation monitoring, mutual support, and communication. Observations recorded on paper forms were stored electronically. Scores were normalized from 1 (low) to 5 (high) to account for different rating scales. Overall mean scores were calculated and graphed; weighted scores adjusted for the number of items in each teamwork domain. Teamwork scores were analyzed using t-tests, pair-wise correlations, and the Kruskal-Wallis statistic, and team performance was compared across instruments by domain. The 9 tools incorporated 5 major domains, with 5-35 items per instrument for a total of 161 items per observation session. In weighted and unweighted analyses, the overall teamwork performance score for a given team on a given day varied by instrument. While all of the tools identified the same low outlier, high performers on some instruments were low performers on others. Inconsistent scores for a given team across instruments persisted in domain-level analyses. There was substantial variation in the rating of individual teams assessed concurrently by a single observer using multiple instruments. Since existing teamwork observation tools do not yield concordant assessments, researchers should create better tools for measuring teamwork performance.

Comparing Videotapes and Written Narrative Records of Second Grade Reading Classes: Selecting Methods for Particular Observational Goals.

ERIC Educational Resources Information Center

Gardner, C. H.; And Others

The classroom behaviors recorded during three second grade reading lessons provide suitable evidence for comparing the relative merits of using narrative observations versus videotapes as data collection techniques. The comparative analysis illustrates the detail and precision of videotape. Primarily, videotape gives a true picture of linear time,…

An observational study comparing the prototype device with the existing device for the effective visualization of invisible veins in elderly patients in Japan.

PubMed

Kimori, Keiko; Sugama, Junko; Nakatani, Toshio; Nakayama, Kazuya; Miyati, Tosiaki; Sanada, Hiromi

2015-01-01

To compare the performance on the detection of the invisible veins between our modified prototype device and an existing device in elderly hospitalized patients. A prospective, cross-sectional, and observational study was performed in the invisible veins in elderly patients. The major variables, skin color near the invisible veins, and diameter and depth of the invisible veins were measured. The vein visualization rate was calculated as the ratio of the visualized veins to the invisible veins by the visualization device. We analyzed 53 invisible veins in the cubital fossa and 56 invisible veins in the forearm in a total of 72 patients (median age, 73 years). The visualization rate for our prototype device was higher than that for an existing device in the cubital fossa and the forearm sites. The visualized veins of the prototype device had a higher intensity ratio than that of an existing device. No significant differences were observed in the body mass index, vein depth, and vein diameter of the visualized veins at the cubital fossa and forearm sites. The prototype surpassed the existing device in visualizing the invisible veins. However, the prototype was unable to visualize all the invisible veins. We need to look for ways to reduce noise and to visualize the invisible veins, and the visualization rate of devices needs to be investigated in further association with the percentage of success with actual intravenous access and locating time to vein.

[Comparative Study of Patient Identifications for Conventional and Portable Chest Radiographs Utilizing ROC Analysis].

PubMed

Kawashima, Hiroki; Hayashi, Norio; Ohno, Naoki; Matsuura, Yukihiro; Sanada, Shigeru

2015-08-01

To evaluate the patient identification ability of radiographers, previous and current chest radiographs were assessed with observer study utilizing a receiver operating characteristics (ROCs) analysis. This study included portable and conventional chest radiographs from 43 same and 43 different patients. The dataset used in this study was divided into the three following groups: (1) a pair of portable radiographs, (2) a pair of conventional radiographs, and (3) a combination of each type of radiograph. Seven observers participated in this ROC study, which aimed to identify same or different patients, using these datasets. ROC analysis was conducted to calculate the average area under ROC curve obtained by each observer (AUCave), and a statistical test was performed using the multi-reader multi-case method. Comparable results were obtained with pairs of portable (AUCave: 0.949) and conventional radiographs (AUCave: 0.951). In a comparison between the same modality, there were no significant differences. In contrast, the ability to identify patients by comparing a portable and conventional radiograph (AUCave: 0.873) was lower than with the matching datasets (p=0.002 and p=0.004, respectively). In conclusion, the use of different imaging modalities reduces radiographers' ability to identify their patients.

EFQPSK Versus CERN: A Comparative Study

NASA Technical Reports Server (NTRS)

Borah, Deva K.; Horan, Stephen

2001-01-01

This report presents a comparative study on Enhanced Feher's Quadrature Phase Shift Keying (EFQPSK) and Constrained Envelope Root Nyquist (CERN) techniques. These two techniques have been developed in recent times to provide high spectral and power efficiencies under nonlinear amplifier environment. The purpose of this study is to gain insights into these techniques and to help system planners and designers with an appropriate set of guidelines for using these techniques. The comparative study presented in this report relies on effective simulation models and procedures. Therefore, a significant part of this report is devoted to understanding the mathematical and simulation models of the techniques and their set-up procedures. In particular, mathematical models of EFQPSK and CERN, effects of the sampling rate in discrete time signal representation, and modeling of nonlinear amplifiers and predistorters have been considered in detail. The results of this study show that both EFQPSK and CERN signals provide spectrally efficient communications compared to filtered conventional linear modulation techniques when a nonlinear power amplifier is used. However, there are important differences. The spectral efficiency of CERN signals, with a small amount of input backoff, is significantly better than that of EFQPSK signals if the nonlinear amplifier is an ideal clipper. However, to achieve such spectral efficiencies with a practical nonlinear amplifier, CERN processing requires a predistorter which effectively translates the amplifier's characteristics close to those of an ideal clipper. Thus, the spectral performance of CERN signals strongly depends on the predistorter. EFQPSK signals, on the other hand, do not need such predistorters since their spectra are almost unaffected by the nonlinear amplifier, Ibis report discusses several receiver structures for EFQPSK signals. It is observed that optimal receiver structures can be realized for both coded and uncoded EFQPSK

What is AIDS in Guadeloupe? A descriptive and comparative study.

PubMed

Elenga, Narcisse; Georger-Sow, Marie-Thérèse; Messiaen, Thierry; Lamaury, Isabelle; Favre, Isabelle; Nacher, Mathieu; Beaucaire, Gilles

2014-03-01

Since the pathogen ecology differs between Caribbean regions, specific differences in the most frequent clinical presentations of acquired immunodeficiency syndrome (AIDS) may be expected. We therefore conducted the present retrospective cohort study in order to describe the main AIDS-defining events in Guadeloupe and to compare them with those observed in Metropolitan France and in French Guiana. We discuss the local pathogen ecology, the diagnostic limitations of hospitals in overseas territories and the drivers of the epidemic.

A cross-sectional observational study comparing foot and ankle characteristics in people with stroke and healthy controls.

PubMed

Kunkel, Dorit; Potter, Julia; Mamode, Louis

2017-06-01

The purpose of this study was to explore and compare foot and ankle characteristics in people with stroke and healthy controls; and between stroke fallers and non-fallers. Participants were recruited from community groups and completed standardized tests assessing sensation, foot posture, foot function, ankle dorsiflexion and first metatarsal phalangeal joint range of motion (1st MPJ ROM), hallux valgus presence and severity. Twenty-three stroke participants (mean age 75.09 ± 7.57 years; 12 fallers) and 16 controls (mean age 73.44 ± 8.35 years) took part. Within the stroke group, reduced 1st MPJ sensation (p = 0.016) and 1st MPJ ROM (p = 0.025) were observed in the affected foot in comparison to the non-affected foot; no other differences were apparent. Pooled data (for both feet) was used to explore between stroke/control (n = 78 feet) and stroke faller/non-faller (n = 46 feet) group differences. In comparison to the control group, stroke participants exhibited reduced sensation of the 1st MPJ (p = 0.020), higher Foot Posture Index scores (indicating greater foot pronation, p = 0.008) and reduced foot function (p = 0.003). Stroke fallers exhibited significantly greater foot pronation in comparison to non-fallers (p = 0.027). Results indicated differences in foot and ankle characteristics post stroke in comparison to healthy controls. These changes may negatively impact functional ability and the ability to preserve balance. Further research is warranted to explore the influence of foot problems on balance ability and falls in people with stroke. Implications for Rehabilitation Foot problems are common post stroke. As foot problems have been linked to increased fall risk among the general population we recommend that it would be beneficial to include foot and ankle assessments or a referral to a podiatrist for people with stroke who report foot problems. Further research is needed to explore if we can improve functional

Compliance with Seat Belt Use in Makurdi, Nigeria: An Observational Study

PubMed Central

Popoola, SO; Oluwadiya, KS; Kortor, JN; Denen-Akaa, P; Onyemaechi, NOC

2013-01-01

Background: Seat belts are designed to reduce injuries due to road crash among vehicle occupants. Aims: This study aims to determine the availability of seat belt in vehicles and compliance with seat belt use among vehicle occupants. Materials and methods: This was a 24-h direct observational study of seat belt usage among vehicle occupants in Makurdi, Benue State, Nigeria. By direct surveillance and using a datasheet, we observed 500 vehicles and their occupants for seat belt availability and compliance with its use. Chi-square test was used for test of significance between variables. Results: Twenty-five (5.0%) of the observed 500 vehicles had no seat belt at all. Overall, compliance was 277/486 (57.0%). Use of seat belt was highest in the afternoon with 124/194 (64.4%), followed by 111/188 (59.0%) in the morning and 42/95 (44.2%) at night. Compliance was highest among car occupants [209/308 (67.9%)] and private vehicles, and lowest among commercial vehicle occupants. Compliance among female drivers was 77.1% compared with 51.4% among male drivers. Among drivers, the mean age of seat belt users was 38.4 (7.7) years, which was significantly younger than the 41.3 (8.7) years mean age of non-users. Similar figures were obtained among other vehicle occupants. Conclusions: Compared with previous studies, seat belt usage has improved among Nigerian road users, but there is still room for improvement, especially early in the mornings and at nights. Since these were times when law enforcement agencies were not likely to be on the roads, we advocate for improved coverage by enforcement agents to enforce better compliance. PMID:24116327

Prepubertal and postpubertal vitiligo: a multivariate comparative study in 375 patients.

PubMed

Khurrum, Huma; AlGhamdi, Khalid M

2017-01-01

The onset of vitiligo during childhood is common. Limited data exist that compare the clinical associations of prepubertal and postpubertal vitiligo in Arabs. To compare the clinical profile of pre and postpubertal onset vitiligo. A cross-sectional observational study was conducted. The Vitiligo European Task Force questionnaire was completed for each patient. A total of 375 patients were included; 199 had postpubertal vitiligo (>12 years), and 176 had prepubertal onset vitiligo (<12years). There were more females in the prepubertal group (49%) than in the postpubertal group (29%), p-value <0.001. The prepubertal group has had more involvement than the postpubertal group (45% vs 30%, p=0.004). Only 8 cases of segmental vitiligo were observed; five were observed in the prepubertal group of patients. Female gender (OR=2.3; 95% CI:1.5, 3.5), presence of halo nevus (OR=2.2; 95% CI:1.1, 4.4) and face involvement (OR=1.9; 95% CI:1.2, 2.9) were positively associated with prepubertal vitiligo. Stress, as an onset factor, was positively associated (OR=0.51; 95% CI:0.3, 0.8) with postpubertal onset vitiligo. A possible selection bias toward more severe vitiligo cases can be a limitation, because the study was conducted in a clinic specialized in vitiligo. Moreover, a likelihood of false recall bias cannot be excluded. Our data present clinical evidence that vitiligo behaves mostly the same way in the prepubertal group as in the postpubertal group. However, female over-representation, more face involvement and more halo nevi were observed in prepubertal vitiligo, while stress was more prevalent as an aggravating factor in postpubertal vitiligo patients.

3-D microphysical model studies of Arctic denitrification: comparison with observations

NASA Astrophysics Data System (ADS)

Davies, S.; Mann, G. W.; Carslaw, K. S.; Chipperfield, M. P.; Kettleborough, J. A.; Santee, M. L.; Oelhaf, H.; Wetzel, G.; Sasano, Y.; Sugita, T.

2005-11-01

Simulations of Arctic denitrification using a 3-D chemistry-microphysics transport model are compared with observations for the winters 1994/95, 1996/97 and 1999/2000. The model of Denitrification by Lagrangian Particle Sedimentation (DLAPSE) couples the full chemical scheme of the 3-D chemical transport model, SLIMCAT, with a nitric acid trihydrate (NAT) growth and sedimentation scheme. We use observations from the Microwave Limb Sounder (MLS) and Improved Limb Atmospheric Sounder (ILAS) satellite instruments, the balloon-borne Michelsen Interferometer for Passive Atmospheric Sounding (MIPAS-B), and the in situ NOy instrument on-board the ER-2. As well as directly comparing model results with observations, we also assess the extent to which these observations are able to validate the modelling approach taken. For instance, in 1999/2000 the model captures the temporal development of denitrification observed by the ER-2 from late January into March. However, in this winter the vortex was already highly denitrified by late January so the observations do not provide a strong constraint on the modelled rate of denitrification. The model also reproduces the MLS observations of denitrification in early February 2000. In 1996/97 the model captures the timing and magnitude of denitrification as observed by ILAS, although the lack of observations north of ~67° N in the beginning of February make it difficult to constrain the actual timing of onset. The comparison for this winter does not support previous conclusions that denitrification must be caused by an ice-mediated process. In 1994/95 the model notably underestimates the magnitude of denitrification observed during a single balloon flight of the MIPAS-B instrument. Agreement between model and MLS HNO3 at 68 hPa in mid-February 1995 is significantly better. Sensitivity tests show that a 1.5 K overall decrease in vortex temperatures, or a factor 4 increase in assumed NAT nucleation rates, produce the best statistical

3-D microphysical model studies of Arctic denitrification: comparison with observations

NASA Astrophysics Data System (ADS)

Davies, S.; Mann, G. W.; Carslaw, K. S.; Chipperfield, M. P.; Kettleborough, J. A.; Santee, M. L.; Oelhaf, H.; Wetzel, G.; Sasano, Y.; Sugita, T.

2005-01-01

Simulations of Arctic denitrification using a 3-D chemistry-microphysics transport model are compared with observations for the winters 1994/1995, 1996/1997 and 1999/2000. The model of Denitrification by Lagrangian Particle Sedimentation (DLAPSE) couples the full chemical scheme of the 3-D chemical transport model, SLIMCAT, with a nitric acid trihydrate (NAT) growth and sedimentation scheme. We use observations from the Microwave Limb Sounder (MLS) and Improved Limb Atmospheric Sounder (ILAS) satellite instruments, the balloon-borne Michelsen Interferometer for Passive Atmospheric Sounding (MIPAS-B), and the in situ NOy instrument on-board the ER-2. As well as directly comparing model results with observations, we also assess the extent to which these observations are able to validate the modelling approach taken. For instance, in 1999/2000 the model captures the temporal development of denitrification observed by the ER-2 from late January into March. However, in this winter the vortex was already highly denitrified by late January so the observations do not provide a strong constraint on the modelled rate of denitrification. The model also reproduces the MLS observations of denitrification in early February 2000. In 1996/1997 the model captures the timing and magnitude of denitrification as observed by ILAS, although the lack of observations north of ~67° N make it difficult to constrain the actual timing of onset. The comparison for this winter does not support previous conclusions that denitrification must be caused by an ice-mediated process. In 1994/1995 the model notably underestimates the magnitude of denitrification observed during a single balloon flight of the MIPAS-B instrument. Agreement between model and MLS HNO3 at 68 hPa in mid-February 1995 was significantly better. Sensitivity tests show that a 1.5 K overall decrease in vortex temperatures or a factor 4 increase in assumed NAT nucleation rates produce the best statistical fit to MLS observations

A Hierarchical and Dynamic Seascape Framework for Scaling and Comparing Ocean Biodiversity Observations

NASA Astrophysics Data System (ADS)

Kavanaugh, M.; Muller-Karger, F. E.; Montes, E.; Santora, J. A.; Chavez, F.; Messié, M.; Doney, S. C.

2016-02-01

The pelagic ocean is a complex system in which physical, chemical and biological processes interact to shape patterns on multiple spatial and temporal scales and levels of ecological organization. Monitoring and management of marine seascapes must consider a hierarchical and dynamic mosaic, where the boundaries, extent, and location of features change with time. As part of a Marine Biodiversity Observing Network demonstration project, we conducted a multiscale classification of dynamic coastal seascapes in the northeastern Pacific and Gulf of Mexico using multivariate satellite and modeled data. Synoptic patterns were validated using mooring and ship-based observations that spanned multiple trophic levels and were collected as part of several long-term monitoring programs, including the Monterey Bay and Florida Keys National Marine Sanctuaries. Seascape extent and habitat diversity varied as a function of both seasonal and interannual forcing. We discuss the patterns of in situ observations in the context of seascape dynamics and the effect on rarefaction, spatial patchiness, and tracking and comparing ecosystems through time. A seascape framework presents an effective means to translate local biodiversity measurements to broader spatiotemporal scales, scales relevant for modeling the effects of global change and enabling whole-ecosystem management in the dynamic ocean.

Functional outcome after primary endovascular therapy or IV thrombolysis alone for stroke. An observational, comparative effectiveness study.

PubMed

Abilleira, Sònia; Ribera, Aida; Dávalos, Antonio; Ribó, Marc; Chamorro, Angel; Cardona, Pere; Molina, Carlos A; Martínez-Yélamos, Antonio; Urra, Xabier; Dorado, Laura; Roquer, Jaume; Martí-Fàbregas, Joan; Aja, Lucía; Tomasello, Alejandro; Castaño, Carlos; Blasco, Jordi; Cánovas, David; Castellanos, Mar; Krupinski, Jerzy; Guimaraens, Leopoldo; Perendreu, Joan; Ustrell, Xavier; Purroy, Francisco; Gómez-Choco, Manuel; Baiges, Joan Josep; Cocho, Dolores; Saura, Júlia; Gallofré, Miquel

2014-01-01

Among the acute ischemic stroke patients with large vessel occlusions and contraindications for the use of IV thrombolysis, mainly on oral anticoagulation or presenting too late, primary endovascular therapy is often performed as an alternative to the standard therapy even though evidence supporting the use of endovascular reperfusion therapies is not yet established. Using different statistical approaches, we compared the functional independence rates at 3 months among patients undergoing primary endovascular therapy and patients treated only with IV thrombolysis. We used data from a prospective, government-mandated and externally audited registry of reperfusion therapies for ischemic stroke (January 2011 to November 2012). Patients were selected if treated with either IV thrombolysis alone (n = 1,582) or primary endovascular thrombectomy (n = 250). A series of exclusions were made to homogenize the clinical characteristics among the two groups. We then carried out multivariate logistic regression and propensity score matching analyses on the final study sample (n = 1,179) to compare functional independence at 3 months, as measured by the modified Rankin scale scores 0-2, between the two groups. The unadjusted likelihood of good outcome was poorer among the endovascular group (OR: 0.69; 95% CI: 0.47-1.0). After adjustment, no differences by treatment modality were seen (OR: 1.51; 95% CI: 0.93-2.43 for primary endovascular therapy). Patients undergoing endovascular thrombectomy within 180-270 min (OR: 2.89; 95% CI: 1.17-7.15) and patients with severe strokes (OR: 1.84; 95% CI: 1.02-3.35) did better than their intravenous thrombolysis counterparts. The propensity score-matched analyses with and without adjustment by additional covariates showed that endovascular thrombectomy was as effective as intravenous thrombolysis alone in achieving functional independence (OR for unadjusted propensity score matched: 1.35; 95% CI: 0.9-2.02, OR for adjusted propensity score

Results of Observational Studies: Analysis of Findings from the Nurses’ Health Study

PubMed Central

Tai, Vicky; Grey, Andrew; Bolland, Mark J.

2014-01-01

Background The role of observational studies in informing clinical practice is debated, and high profile examples of discrepancies between the results of observational studies and randomised controlled trials (RCTs) have intensified that debate. We systematically reviewed findings from the Nurses’ Health Study (NHS), one of the longest and largest observational studies, to assess the number and strength of the associations reported and to determine if they have been confirmed in RCTs. Methods We reviewed NHS publication abstracts from 1978–2012, extracted information on associations tested, and graded the strength of the reported effect sizes. We searched PubMed for RCTs or systematic reviews for 3 health outcomes commonly reported in NHS publications: breast cancer, ischaemic heart disease (IHD) and osteoporosis. NHS results were compared with RCT results and deemed concordant when the difference in effect sizes between studies was ≤0.15. Findings 2007 associations between health outcomes and independent variables were reported in 1053 abstracts. 58.0% (1165/2007) were statistically significant, and 22.2% (445/2007) were neutral (no association). Among the statistically significant results that reported a numeric odds ratio (OR) or relative risk (RR), 70.5% (706/1002) reported a weak association (OR/RR 0.5–2.0), 24.5% (246/1002) a moderate association (OR/RR 0.25–0.5 or 2.0–4.0) and 5.0% (50/1002) a strong association (OR/RR ≤0.25 or ≥4.0). 19 associations reported in NHS publications for breast cancer, IHD and osteoporosis have been tested in RCTs, and the concordance between NHS and RCT results was low (≤25%). Conclusions NHS publications contain a large number of analyses, the majority of which reported statistically significant but weak associations. Few of these associations have been tested in RCTs, and where they have, the agreement between NHS results and RCTs is poor. PMID:25330007

Gas kinematics in FIRE simulated galaxies compared to spatially unresolved H I observations

NASA Astrophysics Data System (ADS)

El-Badry, Kareem; Bradford, Jeremy; Quataert, Eliot; Geha, Marla; Boylan-Kolchin, Michael; Weisz, Daniel R.; Wetzel, Andrew; Hopkins, Philip F.; Chan, T. K.; Fitts, Alex; Kereš, Dušan; Faucher-Giguère, Claude-André

2018-06-01

The shape of a galaxy's spatially unresolved, globally integrated 21-cm emission line depends on its internal gas kinematics: galaxies with rotationally supported gas discs produce double-horned profiles with steep wings, while galaxies with dispersion-supported gas produce Gaussian-like profiles with sloped wings. Using mock observations of simulated galaxies from the FIRE project, we show that one can therefore constrain a galaxy's gas kinematics from its unresolved 21-cm line profile. In particular, we find that the kurtosis of the 21-cm line increases with decreasing V/σ and that this trend is robust across a wide range of masses, signal-to-noise ratios, and inclinations. We then quantify the shapes of 21-cm line profiles from a morphologically unbiased sample of ˜2000 low-redshift, H I-detected galaxies with Mstar = 107-11 M⊙ and compare to the simulated galaxies. At Mstar ≳ 1010 M⊙, both the observed and simulated galaxies produce double-horned profiles with low kurtosis and steep wings, consistent with rotationally supported discs. Both the observed and simulated line profiles become more Gaussian like (higher kurtosis and less-steep wings) at lower masses, indicating increased dispersion support. However, the simulated galaxies transition from rotational to dispersion support more strongly: at Mstar = 108-10 M⊙, most of the simulations produce more Gaussian-like profiles than typical observed galaxies with similar mass, indicating that gas in the low-mass simulated galaxies is, on average, overly dispersion supported. Most of the lower-mass-simulated galaxies also have somewhat lower gas fractions than the median of the observed population. The simulations nevertheless reproduce the observed line-width baryonic Tully-Fisher relation, which is insensitive to rotational versus dispersion support.

Patients’ subjective concepts about primary healthcare utilisation: the study protocol of a qualitative comparative study between Norway and Germany

PubMed Central

Herrmann, Wolfram J; Haarmann, Alexander; Flick, Uwe; Bærheim, Anders; Lichte, Thomas; Herrmann, Markus

2013-01-01

Background In Germany, utilisation of ambulatory healthcare services is high compared with other countries: While a study based on the process data of German statutory health insurances showed an average of 17.1 physician-patient-contacts per year, the comparable figure for Norway is about five. The usual models of healthcare utilisation, such as Rosenstock's Health Belief Model and Andersen's Behavioural Model, cannot explain these differences adequately. Organisational factors of the healthcare system, such as gatekeeping, do not explain the magnitude of the differences. Our hypothesis is that patients’ subjective concepts about primary healthcare utilisation play a major role in explaining different healthcare utilisation behaviour in different countries. Hence, the aim of this study is to explore these subjective concepts comparatively, between Germany and Norway. Methods/design With that aim in mind, we chose a comparative qualitative study design. In Norway and Germany, we are going to interview 20 patients each with qualitative episodic interviews. In addition, we are going to conduct participant observation in four German and four Norwegian primary care practices. The data will be analysed by thematic coding. Using selected categories, we are going to conduct comparative case and group analyses. Ethics and dissemination The study adheres to the Declaration of Helsinki. All interviewees will sign informed consent forms and all patients will be observed during consultation. Strict rules for data security will apply. Developed theory and policy implications are going to be disseminated by a workshop, presentations for experts and laypersons and publications. PMID:23794555

Embedding clinical interventions into observational studies

PubMed Central

Newman, Anne B.; Avilés-Santa, M. Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm. James; Krucoff, Mitchell; Kuller, Lewis H.; Lewis, Cora E.; Robinson, Jennifer G.; Taylor, Herman; Treviño, Roberto P.; Weintraub, William

2017-01-01

Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. PMID:26611435

Energetics of a Global Ocean Circulation Model Compared to Observations

DTIC Science & Technology

2011-08-09

rings of the boundary currents [ Stammer , 1997; Ferrari and Wunsch, 2009, 2010], is generated by instabilities of the mean flow and direct wind forcing...of the abyssal ocean circulation in the OGCMs? [4] Resolution studies [Bryan et al., 2007 ; Smith et al., 2000; Hogan and Hurlburt, 2000; Oschlies...surface drifter observations [Lumpkin and Pazos, 2007 ], satellite altimetry (150 m) [Ducet et al., 2000], ARGO floats at 1000 m [Lebedev et al., 2007 ], and

In multiple situational light settings, visual observation for skin colour assessment is comparable with colorimeter measurement.

PubMed

Wright, C Y; Wilkes, M; du Plessis, J L; Reeder, A I; Albers, P N

2016-08-01

Finding inexpensive and reliable techniques for assessing skin colour is important, given that it is related to several adverse human health outcomes. Visual observation is considered a subjective approach assessment and, even when made by trained assessor, concern has been raised about the need for controlled lighting in the study venue. The aim of this study is to determine whether visual skin colour assessments correlate with objective skin colour measurements in study venues with different lighting types and configurations. Two trained investigators, with confirmed visual acuity, visually classified the inner, upper arm skin colour of 556 adults using Munsell(®) colour classifications converted to Individual Typology Angle (°ITA) values based on published data. Skin colour at the same anatomic site was also measured using a colorimeter. Each participant was assessed in one of 10 different buildings, each with a different study day. Munsell(®) -derived °ITA values were compared to colorimeter °ITA values for the full sample and by building/day. We found a strong positive, monotonic correlation between Munsell(®) derived °ITA values and colorimeter °ITA values for all participants (Spearman ρ = 0.8585, P < 0.001). Similar relationships were found when Munsell(®) and colorimeter °ITA values were compared for participants assessed in the same building for all 10 buildings (Spearman ρ values ranged from 0.797 to 0.934, all correlations were statistically significant at P < 0.001). It is possible to visually assess individual skin colour in multiple situational lighting settings and retrieve results that are comparable with objective measurements of skin colour. This was true for individuals of varying population groups and skin pigmentation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A comparative study of two-piece ostomy appliances.

PubMed

Welser, Marion; Riedlinger, Inge; Prause, Ulla

The quality of life of people with a stoma may be affected by peristomal skin disorders and by frequent unplanned changes of ostomy appliances due to problems with those appliances. The aim of this study was to evaluate two new, two-piece ostomy appliances with mechanical couplings (both from the SenSura range by Coloplast) and their ability to address areas that may be important to the quality of life of people with stomas, including appliance changes, stool seepage and overfilling. The study design featured two comparative, crossover, randomized multi-centre studies that were conducted in Germany. The SenSura appliances were evaluated against established reference appliances. Seventy-three individuals with a colostomy (closed-end appliances) and 75 individuals with an ileostomy (drainable appliances) participated in the studies. The participants tested 4-6 flanges of each type within a maximum period of two weeks. The results demonstrated that there was less seepage of stool observed under the SenSura flange when it was removed (p<0.05). Also, there were fewer unplanned changes (p<0.0005) seen with SenSura than with the reference appliances. The SenSura flanges had better adhesion and flexibility and were easier to remove than the references (p<0.0005), and they had greater resistance to erosion (p<0.05). In conclusion, SenSura performed better than the reference appliances on quality of life indicators - there were fewer unplanned changes and less seepage of stool was observed in patients using the SenSura products.

Comparing potential-driven DBI-inspired non-minimal kinetic coupling (Dinkic) inflation with observational data

NASA Astrophysics Data System (ADS)

Chen, Jun; Hou, Wenjie; Qiu, Taotao; Hou, Defu

2018-04-01

In our previous work [1], a new kind of inflation model was proposed, which has the interesting property that its perturbation equation of motion gets a correction of k 4, due to the non-linearity of the kinetic term. Nonetheless, the scale-invariance of the power spectrum remains valid, both in large-k and small-k limits. In this paper, we investigate in detail the spectral index, the index running and the tensor/scalar ratio in this model, especially in the potential-driven case, and compare the results with the current PLANCK/BICEP observational data. We also discuss the tensor spectrum in this case, which is expected to be tested by future observations of primordial gravitational waves. Supported by NSFC (11405069, 11653002, 11735007, 111375070)

Observational study of atmospheric surface layer and coastal weather in northern Qatar

NASA Astrophysics Data System (ADS)

Samanta, Dhrubajyoti; Sadr, Reza

2016-04-01

Atmospheric surface layer is the interaction medium between atmosphere and Earth's surface. Better understanding of its turbulence nature is essential in characterizing the local weather, climate variability and modeling of turbulent exchange processes. The importance of Middle East region, with its unique geographical, economical and weather condition is well recognized. However, high quality micrometeorological observational studies are rare in this region. Here we show experimental results from micrometeorological observations from an experimental site in the coastal region of Qatar during August-December 2015. Measurements of winds are obtained from three sonic anemometers installed on a 9 m tower placed at Al Ghariyah beach in northern Qatar (26.08 °N, 51.36 °E). Different surface layer characteristics is analyzed and compared with earlier studies in equivalent weather conditions. Monthly statistics of wind speed, wind direction, temperature, humidity and heat index are made from concurrent observations from sonic anemometer and weather station to explore variations with surface layer characteristics. The results also highlights potential impact of sea breeze circulation on local weather and atmospheric turbulence. The observed daily maximum temperature and heat index during morning period may be related to sea breeze circulations. Along with the operational micrometeorological observation system, a camera system and ultrasonic wave measurement system are installed recently in the site to study coastline development and nearshore wave dynamics. Overall, the complete observational set up is going to provide new insights about nearshore wind dynamics and wind-wave interaction in Qatar.

Comparative study on the biodegradability of morpholinium herbicidal ionic liquids.

PubMed

Ławniczak, Łukasz; Materna, Katarzyna; Framski, Grzegorz; Szulc, Alicja; Syguda, Anna

2015-07-01

This study focused on evaluating the toxicity as well as primary and ultimate biodegradability of morpholinium herbicidal ionic liquids (HILs), which incorporated MCPA, MCPP, 2,4-D or Dicamba anions. The studied HILs were also subjected to determination of surface active properties in order to assess their influence on toxicity and biodegradability. The study was carried out with microbiota isolated from different environmental niches: sediments from river channel, garden soil, drainage trench collecting agricultural runoff stream, agricultural soil and municipal waste repository. The obtained results revealed that resistance to toxicity and biodegradation efficiency of the microbiota increased in the following order: microbiota from the waste repository > microbiota from agricultural soil ≈ microbiota from an agricultural runoff stream > microbiota from garden soil > microbiota from the river sludge. It was observed that the toxicity of HILs increased with the hydrophobicity of the cation, however the influence of the anion was more notable. The highest toxicity was observed when MCPA was used as the anion (EC50 values ranging from 60 to 190 mg L(-1)). The results of ultimate biodegradation tests indicated that only HILs with 2,4-D as the anion were mineralized to some extent, with slightly higher values for HILs with the 4-decyl-4-ethylmorpholinium cation (10-31 %) compared to HILs with the 4,4-didecylmorpholinium cation (9-20 %). Overall, the cations were more susceptible (41-94 %) to primary biodegradation compared to anions (0-61 %). The obtained results suggested that the surface active properties of the studied HILs may influence their toxicity and biodegradability by bacteria in different environmental niches.

Simultaneous Observations of TADs in GOCE, CHAMP and GRACE Density Data Compared with CTIPe

NASA Astrophysics Data System (ADS)

Bruinsma, S. L.; Fedrizzi, M.

2012-12-01

The accelerometers on the CHAMP and GRACE satellites have made it possible to accumulate near-continuous records of thermosphere density between about 300 and 490 km since May 2001, and July 2002, respectively. Since November 2009, a third gravity field satellite mission, ESA's GOCE, is in a very low and near heliosynchronous dawn-dusk orbit at about 270 km. The spacecraft is actively maintained at that constant altitude using an ion propulsion engine that compensates the aerodynamic drag in the flight direction. The thrust level, combined with accelerometer and satellite attitude data, is used to compute atmospheric densities and cross-track winds. The response of the thermosphere to geomagnetic disturbances, i.e., space weather, has been extensively studied using the exceptional datasets of CHAMP and GRACE. Thanks to GOCE we now have a third excellent data set for these studies. In this presentation we will show the observed density and its variability for the geomagnetic storm of 5 April 2010, and compare it with predictions along the orbits obtained from a self-consistent physics-based coupled model of the thermosphere, ionosphere, plasmasphere and electrodynamics (CTIPe). For this storm, the CHAMP and GOCE orbit planes were perpendicular (12/24 Local Solar Time, and 6/18 LST, respectively) and the altitude difference was only approximately 30 km. The GRACE densities are at a much higher altitude of about 475 km. Wave-like features are revealed or enhanced after filtering of the densities and calculation of relative density variations. Traveling Atmospheric Disturbances are observed in the data, and the model's fidelity in reproducing the waves is evaluated.

Embedding clinical interventions into observational studies.

PubMed

Newman, Anne B; Avilés-Santa, M Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm James; Krucoff, Mitchell; Kuller, Lewis H; Lewis, Cora E; Robinson, Jennifer G; Taylor, Herman; Treviño, Roberto P; Weintraub, William

2016-01-01

Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. Copyright © 2015. Published by Elsevier Inc.

Comparing a marginal structural model with a Cox proportional hazard model to estimate the effect of time-dependent drug use in observational studies: statin use for primary prevention of cardiovascular disease as an example from the Rotterdam Study.

PubMed

de Keyser, Catherine E; Leening, Maarten J G; Romio, Silvana A; Jukema, J Wouter; Hofman, Albert; Ikram, M Arfan; Franco, Oscar H; Stijnen, Theo; Stricker, Bruno H

2014-11-01

When studying the causal effect of drug use in observational data, marginal structural modeling (MSM) can be used to adjust for time-dependent confounders that are affected by previous treatment. The objective of this study was to compare traditional Cox proportional hazard models (with and without time-dependent covariates) with MSM to study causal effects of time-dependent drug use. The example of primary prevention of cardiovascular disease (CVD) with statins was examined using up to 17.7 years of follow-up from 4,654 participants of the observational prospective population-based Rotterdam Study. In the MSM model, the weight was based on measurements of established cardiovascular risk factors and co-morbidity. In general, we could not demonstrate important differences in results from the Cox models and MSM. Results from analysis on duration of statin use suggested that substantial residual confounding by indication was not accounted for during the period shortly after statin initiation. In conclusion, although on theoretical grounds MSM is an elegant technique, lack of data on the precise time-dependent confounders, such as indication of treatment or other considerations of the prescribing physician jeopardizes the calculation of valid weights. Confounding remains a hurdle in observational effectiveness research on preventive drugs with a multitude of prescription determinants.

Using Multiple Control Groups and Matching to Address Unobserved Biases in Comparative Effectiveness Research: An Observational Study of the Effectiveness of Mental Health Parity.

PubMed

Yoon, Frank B; Huskamp, Haiden A; Busch, Alisa B; Normand, Sharon-Lise T

2011-06-21

Studies of large policy interventions typically do not involve randomization. Adjustments, such as matching, can remove the bias due to observed covariates, but residual confounding remains a concern. In this paper we introduce two analytical strategies to bolster inferences of the effectiveness of policy interventions based on observational data. First, we identify how study groups may differ and then select a second comparison group on this source of difference. Second, we match subjects using a strategy that finely balances the distributions of key categorical covariates and stochastically balances on other covariates. An observational study of the effect of parity on the severely ill subjects enrolled in the Federal Employees Health Benefits (FEHB) Program illustrates our methods.

Interprofessional primary care team meetings: a qualitative approach comparing observations with personal opinions.

PubMed

van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia; Daniëls, Ramon; Lenzen, Stephanie Anna; van der Weijden, Trudy; Beurskens, Anna

2017-02-01

The number of people with multiple chronic conditions requiring primary care services increases. Professionals from different disciplines collaborate and coordinate care to deal with the complex health care needs. There is lack of information on current practices regarding interprofessional team (IPT) meetings. This study aimed to improve our understanding of the process of interprofessional collaboration in primary care team meetings in the Netherlands by observing the current practice and exploring personal opinions. Qualitative study involving observations of team meetings and interviews with participants. Eight different IPT meetings (n = 8) in different primary care practices were observed by means of video recordings. Experiences were explored by conducting individual semi-structured interviews (n = 60) with participants (i.e. health care professionals from different disciplines) of the observed team meetings. The data were analysed by means of content analysis. Most participants expressed favourable opinions about their team meetings. However, observations showed that team meetings were more or less hectic, and lacked a clear structure and team coordinator or leader. There appears to be a discrepancy between findings from observations and interviews. From the interviews, four main themes were extracted: (1) Team structure and composition, (2) Patient-centredness, (3) Interaction and (4) Attitude and motivation. IPT meetings could benefit from improvements in structure, patient-centredness and leadership by the chairpersons. Given the discrepancy between observations and interviews, it would appear useful to improve team members' awareness of aspects that could be improved before training them in dealing with specific challenges. © The Author 2016. Published by Oxford University Press.

Distracted Biking: An Observational Study.

PubMed

Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

2016-01-01

Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

A Numerical Climate Observing Network Design Study

NASA Technical Reports Server (NTRS)

Stammer, Detlef

2003-01-01

This project was concerned with three related questions of an optimal design of a climate observing system: 1. The spatial sampling characteristics required from an ARGO system. 2. The degree to which surface observations from ARGO can be used to calibrate and test satellite remote sensing observations of sea surface salinity (SSS) as it is anticipated now. 3. The more general design of an climate observing system as it is required in the near future for CLIVAR in the Atlantic. An important question in implementing an observing system is that of the sampling density required to observe climate-related variations in the ocean. For that purpose this project was concerned with the sampling requirements for the ARGO float system, but investigated also other elements of a climate observing system. As part of this project we studied the horizontal and vertical sampling characteristics of a global ARGO system which is required to make it fully complementary to altimeter data with the goal to capture climate related variations on large spatial scales (less thanAttachment: 1000 km). We addressed this question in the framework of a numerical model study in the North Atlantic with an 1/6 horizontal resolution. The advantage of a numerical design study is the knowledge of the full model state. Sampled by a synthetic float array, model results will therefore allow to test and improve existing deployment strategies with the goal to make the system as optimal and cost-efficient as possible. Attachment: "Optimal observations for variational data assimilation".

THE STAR FORMATION RATE OF TURBULENT MAGNETIZED CLOUDS: COMPARING THEORY, SIMULATIONS, AND OBSERVATIONS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Federrath, Christoph; Klessen, Ralf S., E-mail: christoph.federrath@monash.edu

2012-12-20

The role of turbulence and magnetic fields is studied for star formation in molecular clouds. We derive and compare six theoretical models for the star formation rate (SFR)-the Krumholz and McKee (KM), Padoan and Nordlund (PN), and Hennebelle and Chabrier (HC) models, and three multi-freefall versions of these, suggested by HC-all based on integrals over the log-normal distribution of turbulent gas. We extend all theories to include magnetic fields and show that the SFR depends on four basic parameters: (1) virial parameter {alpha}{sub vir}; (2) sonic Mach number M; (3) turbulent forcing parameter b, which is a measure for themore » fraction of energy driven in compressive modes; and (4) plasma {beta}=2M{sub A}{sup 2}/M{sup 2} with the Alfven Mach number M{sub A}. We compare all six theories with MHD simulations, covering cloud masses of 300 to 4 Multiplication-Sign 10{sup 6} M{sub Sun} and Mach numbers M=3-50 and M{sub A}=1-{infinity}, with solenoidal (b = 1/3), mixed (b = 0.4), and compressive turbulent (b = 1) forcings. We find that the SFR increases by a factor of four between M=5 and 50 for compressive turbulent forcing and {alpha}{sub vir} {approx} 1. Comparing forcing parameters, we see that the SFR is more than 10 times higher with compressive than solenoidal forcing for M=10 simulations. The SFR and fragmentation are both reduced by a factor of two in strongly magnetized, trans-Alfvenic turbulence compared to hydrodynamic turbulence. All simulations are fit simultaneously by the multi-freefall KM and multi-freefall PN theories within a factor of two over two orders of magnitude in SFR. The simulated SFRs cover the range and correlation of SFR column density with gas column density observed in Galactic clouds, and agree well for star formation efficiencies SFE = 1%-10% and local efficiencies {epsilon} = 0.3-0.7 due to feedback. We conclude that the SFR is primarily controlled by interstellar turbulence, with a secondary effect coming from magnetic fields.« less

Match and mismatch - comparing plant phenological metrics from ground-observations and from a prognostic model

NASA Astrophysics Data System (ADS)

Rutishauser, This; Stöckli, Reto; Jeanneret, François; Peñuelas, Josep

2010-05-01

Changes in the seasonality of life cycles of plants as recorded in phenological observations have been widely analysed at the species level with data available for many decades back in time. At the same time, seasonality changes in satellite-based observations and prognostic phenology models comprise information at the pixel-size or landscape scale. Change analysis of satellite-based records is restricted due to relatively short satellite records that further include gaps while model-based analyses are biased due to current model deficiencies., At 30 selected sites across Europe, we analysed three different sources of plant seasonality during the 1971-2000 period. Data consisted of (1) species-specific development stages of flowering and leave-out with different species observed at each site. (2) We used a synthetic phenological metric that integrates the common interannual phenological signal across all species at one site. (3) We estimated daily Leaf Area Index with a prognostic phenology model. The prior uncertainties of the model's empirical parameter space are constrained by assimilating the Fraction of Photosynthetically Active Radiation absorbed by vegetation (FPAR) and Leaf Area Index (LAI) from the MODerate Resolution Imaging Spectroradiometer (MODIS). We extracted the day of year when the 25%, 50% and 75% thresholds were passed each spring. The question arises how the three phenological signals compare and correlate across climate zones in Europe. Is there a match between single species observations, species-based ground-observed metrics and the landscape-scale prognostic model? Are there single key-species across Europe that best represent a landscape scale measure from the prognostic model? Can one source substitute another and serve as proxy-data? What can we learn from potential mismatches? Focusing on changes in spring this contribution presents first results of an ongoing comparison study from a number of European test sites that will be extended to

A comparative study of microwave radiometer observations over snowfields with radiative transfer model calculations. [for water runoff estimation

NASA Technical Reports Server (NTRS)

Chang, A. T. C.; Shiue, J. C.

1979-01-01

Truck mounted microwave instrumentation was used to study the microwave emission characteristics of the Colorado Rocky Mountain snowpack in the vicinity of Fraser, Colorado during the winter of 1978. The spectral signatures of 5.0, 10.7, 18, and 37 GHz radiometers with dual polarization were used to measure the snowpack density and temperature profiles, rain profile, and free water content. These data were compared with calculated results based on microscopic scattering models for dry, surface melting, and very wet snowpacks.

Carboxyhemoglobin levels in medical intensive care patients: a retrospective, observational study

PubMed Central

2012-01-01

Introduction Critical illness leads to increased endogenous production of carbon monoxide (CO) due to the induction of the stress-response enzyme, heme oxygenase-1 (HO-1). There is evidence for the cytoprotective and anti-inflammatory effects of CO based on animal studies. In critically ill patients after cardiothoracic surgery, low minimum and high maximum carboxyhemoglobin (COHb) levels were shown to be associated with increased mortality, which suggests that there is an 'optimal range' for HO-1 activity. Our study aimed to test whether this relationship between COHb and outcome exists in non-surgical ICU patients. Methods We conducted a retrospective, observational study in a medical ICU at a university hospital in Vienna, Austria involving 868 critically ill patients. No interventions were undertaken. Arterial COHb was measured on admission and during the course of treatment in the ICU. The association between arterial COHb levels and ICU mortality was evaluated using bivariate tests and a logistic regression model. Results Minimum COHb levels were slightly lower in non-survivors compared to survivors (0.9%, 0.7% to 1.2% versus 1.2%, 0.9% to 1.5%; P = 0.0001), and the average COHb levels were marginally lower in non-survivors compared to survivors (1.5%, 1.2% to 1.8% versus 1.6%, 1.4% to 1.9%, P = 0.003). The multivariate logistic regression analysis revealed that the association between a low minimum COHb level and increased mortality was independent of the severity of illness and the type of organ failure. Conclusions Critically ill patients surviving the admission to a medical ICU had slightly higher minimum and marginally higher average COHb levels when compared to non-survivors. Even though the observed differences are statistically significant, the minute margins would not qualify COHb as a predictive marker for ICU mortality. PMID:22236404

Carboxyhemoglobin levels in medical intensive care patients: a retrospective, observational study.

PubMed

Fazekas, Andreas S; Wewalka, Marlene; Zauner, Christian; Funk, Georg-Christian

2012-01-11

Critical illness leads to increased endogenous production of carbon monoxide (CO) due to the induction of the stress-response enzyme, heme oxygenase-1 (HO-1). There is evidence for the cytoprotective and anti-inflammatory effects of CO based on animal studies. In critically ill patients after cardiothoracic surgery, low minimum and high maximum carboxyhemoglobin (COHb) levels were shown to be associated with increased mortality, which suggests that there is an 'optimal range' for HO-1 activity. Our study aimed to test whether this relationship between COHb and outcome exists in non-surgical ICU patients. We conducted a retrospective, observational study in a medical ICU at a university hospital in Vienna, Austria involving 868 critically ill patients. No interventions were undertaken. Arterial COHb was measured on admission and during the course of treatment in the ICU. The association between arterial COHb levels and ICU mortality was evaluated using bivariate tests and a logistic regression model. Minimum COHb levels were slightly lower in non-survivors compared to survivors (0.9%, 0.7% to 1.2% versus 1.2%, 0.9% to 1.5%; P=0.0001), and the average COHb levels were marginally lower in non-survivors compared to survivors (1.5%, 1.2% to 1.8% versus 1.6%, 1.4% to 1.9%, P=0.003). The multivariate logistic regression analysis revealed that the association between a low minimum COHb level and increased mortality was independent of the severity of illness and the type of organ failure. Critically ill patients surviving the admission to a medical ICU had slightly higher minimum and marginally higher average COHb levels when compared to non-survivors. Even though the observed differences are statistically significant, the minute margins would not qualify COHb as a predictive marker for ICU mortality.

The Comparative Toxicogenomics Database (CTD): A Resource for Comparative Toxicological Studies

PubMed Central

CJ, Mattingly; MC, Rosenstein; GT, Colby; JN, Forrest; JL, Boyer

2006-01-01

The etiology of most chronic diseases involves interactions between environmental factors and genes that modulate important biological processes (Olden and Wilson, 2000). We are developing the publicly available Comparative Toxicogenomics Database (CTD) to promote understanding about the effects of environmental chemicals on human health. CTD identifies interactions between chemicals and genes and facilitates cross-species comparative studies of these genes. The use of diverse animal models and cross-species comparative sequence studies has been critical for understanding basic physiological mechanisms and gene and protein functions. Similarly, these approaches will be valuable for exploring the molecular mechanisms of action of environmental chemicals and the genetic basis of differential susceptibility. PMID:16902965

A comparative Study of Circulation Patterns at Active Lava Lakes

NASA Astrophysics Data System (ADS)

Lev, Einat; Oppenheimer, Clive; Spampinato, Letizia; Hernandez, Pedro; Unglert, Kathi

2016-04-01

Lava lakes present a rare opportunity to study magma dynamics in a large scaled-up "crucible" and provide a unique natural laboratory to ground-truth dynamic models of magma circulation. The persistence of lava lakes allows for long-term observations of flow dynamics and of lava properties, especially compared to surface lava flows. There are currently five persistent lava lakes in the world: Halemaumau in Kilauea (Hawaii, USA), Erta Ale (Ethiopia), Nyiragongo (Congo), Erebus (Antarctica), and Villarica (Chile). Marum and Benbow craters of Ambrym volcano (Vanuatu) and Masaya (Nicaragua) have often hosted lava lakes as well. We use visible-light and thermal infrared time-lapse and video footage collected at all above lakes (except Villarica, where the lake is difficult to observe), and compare the circulation patterns recorded. We calculate lake surface motion from the footage using the optical flow method (Lev et al., 2012) to produce 2D velocity fields. We mined both the surface temperature field and the surface velocity field for patterns using machine learning techniques such as "self-organizing maps (SOMs)" and "principle component analysis (PCA)". We use automatic detection technique to study the configuration of crustal plates at the lakes' surface. We find striking differences among the lakes, in flow direction, flow speed, frequency of changes in flow direction and speed, location and consistency of upwelling and downwelling, and crustal plate configuration. We relate the differences to lake size, shallow conduit geometry, lava viscosity, crystal and gas content, and crust integrity.

Distracted Biking: An Observational Study

PubMed Central

Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J.

2016-01-01

Commuting via bicycle is a very popular mode of transportation in the Northeastern United States (US). Boston, MA has seen a rapid increase in bicycle ridership over the past decade which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at four high traffic intersections in Boston during various peak commuting hours for two types of distractions: auditory (ear buds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%, 95% CI: 29%-33%) were distracted. Of those observed, auditory distractions were the most common (N= 349 [17.7%, 95% CI: 16%-19%], p=0.0003) followed by visual/tactile distractions (N= 266 [13.5%, 95% CI: 12%-15%]). The highest proportion (40.7%, 95% CI: 35%-46%) of distracted bicyclists was observed during the midday commute (between 13:30-15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost one-third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured. PMID:26953533

A comparative study of the constitutive models for silicon carbide

NASA Astrophysics Data System (ADS)

Ding, Jow-Lian; Dwivedi, Sunil; Gupta, Yogendra

2001-06-01

Most of the constitutive models for polycrystalline silicon carbide were developed and evaluated using data from either normal plate impact or Hopkinson bar experiments. At ISP, extensive efforts have been made to gain detailed insight into the shocked state of the silicon carbide (SiC) using innovative experimental methods, viz., lateral stress measurements, in-material unloading measurements, and combined compression shear experiments. The data obtained from these experiments provide some unique information for both developing and evaluating material models. In this study, these data for SiC were first used to evaluate some of the existing models to identify their strength and possible deficiencies. Motivated by both the results of this comparative study and the experimental observations, an improved phenomenological model was developed. The model incorporates pressure dependence of strength, rate sensitivity, damage evolution under both tension and compression, pressure confinement effect on damage evolution, stiffness degradation due to damage, and pressure dependence of stiffness. The model developments are able to capture most of the material features observed experimentally, but more work is needed to better match the experimental data quantitatively.

Data base to compare calculations and observations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tichler, J.L.

Meteorological and climatological data bases were compared with known tritium release points and diffusion calculations to determine if calculated concentrations could replace measure concentrations at the monitoring stations. Daily tritium concentrations were monitored at 8 stations and 16 possible receptors. Automated data retrieval strategies are listed. (PSB)

Comparative studies on ecotoxicology of synthetic detergents.

PubMed

Lal, H; Misra, V; Viswanathan, P N; Krishna Murti, C R

1983-12-01

To predict the comparative toxicological response of synthetic detergents on aquatic ecosystems, the effects of various concentrations of neutralized alkyl benzene sulfonate were studied. The median tolerance limit at 48 hr, 95% confidence limit, slope function, presumable harmless concentration, and rate of survival of different species of aquatic fauna such as water fleas (Daphnia magna), mosquito larvae (Culex pipiens), slug worms (Tubifex rivulorum), snails (Lymnaea vulgaris), tadpoles (Rana cyanophlyctis), and fish fingerlings (Cirrhina mrigala) were followed at 0, 24, 48, 72, and 96 hr. Any effect on quality of the water was also tested after the addition of various concentrations of detergents. The results showed that water fleas are more susceptible to detergent toxicity than fish fingerlings, tadpoles, slug worms, snails, and mosquito larvae. Behavioral changes were also observed as an index for detergent toxicity. The relative toxicity of the detergents to various species is discussed in relation to selective ecotoxicological response.

The challenges to gender integration in the career fire services: a comparative case study of men in nursing

DTIC Science & Technology

2017-03-01

GENDER INTEGRATION IN THE CAREER FIRE SERVICES: A COMPARATIVE CASE STUDY OF MEN IN NURSING by Anna L. Schermerhorn-Collins March 2017...IN THE CAREER FIRE SERVICES: A COMPARATIVE CASE STUDY OF MEN IN NURSING 5. FUNDING NUMBERS 6. AUTHOR(S) Anna L. Schermerhorn-Collins 7... comparative case study of men in nursing. Research is based in academic and historical accounts, in addition to the use of participant-observation

Extension of Kaplan-Meier methods in observational studies with time-varying treatment.

PubMed

Xu, Stanley; Shetterly, Susan; Powers, David; Raebel, Marsha A; Tsai, Thomas T; Ho, P Michael; Magid, David

2012-01-01

Inverse probability of treatment weighted Kaplan-Meier estimates have been developed to compare two treatments in the presence of confounders in observational studies. Recently, stabilized weights were developed to reduce the influence of extreme inverse probability of treatment-weighted weights in estimating treatment effects. The objective of this research was to use adjusted Kaplan-Meier estimates and modified log-rank and Wilcoxon tests to examine the effect of a treatment that varies over time in an observational study. We proposed stabilized weight adjusted Kaplan-Meier estimates and modified log-rank and Wilcoxon tests when the treatment was time-varying over the follow-up period. We applied these new methods in examining the effect of an anti-platelet agent, clopidogrel, on subsequent events, including bleeding, myocardial infarction, and death after a drug-eluting stent was implanted into a coronary artery. In this population, clopidogrel use may change over time based on a patient's behavior (e.g., nonadherence) and physicians' recommendations (e.g., end of duration of therapy). Consequently, clopidogrel use was treated as a time-varying variable. We demonstrate that 1) the sample sizes at three chosen time points are almost identical in the original and weighted datasets; and 2) the covariates between patients on and off clopidogrel were well balanced after stabilized weights were applied to the original samples. The stabilized weight-adjusted Kaplan-Meier estimates and modified log-rank and Wilcoxon tests are useful in presenting and comparing survival functions for time-varying treatments in observational studies while adjusting for known confounders. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Comparative study of group treatments for posttraumatic stress disorder.

PubMed

Maxwell, Kendal; Callahan, Jennifer L; Holtz, Pamela; Janis, Beth M; Gerber, Monica M; Connor, Dana R

2016-12-01

Presented herein is a comparative study of group treatments for posttraumatic stress disorder (PTSD). In this study, an emerging intervention, memory specificity training (MeST), was compared with cognitive processing therapy (CPT) using standardized outcome measures of target symptoms (i.e., anxiety and depression from client perspective; memory specificity from independent rater perspective) and global functioning (independent rater perspective), as well as a process measure of expectancy (client perspective). Clients were assessed on 3 separate occasions: at baseline, posttreatment, and 3 months posttreatment. Adherence and treatment fidelity (independent rater perspective) were monitored throughout the course of both treatment conditions. Improvement in PTSD symptoms, depressive symptoms, and global functioning were similar between MeST and CPT; an increase in ability to specify memories upon retrieval was also similar between MeST and CPT. Positive reliable change was observed in both groups on all outcome measures. With respect to the primary target of PTSD symptoms, 88% of participants in both treatment groups moved into the functional distribution by posttreatment and maintained these gains at follow-up. Notably, compared with CPT, MeST required only half the dosage (i.e., number of sessions) to accomplish these gains. Illustrative vignettes from client-therapist exchanges are provided, and results are discussed in terms of the potential mechanisms of action. Implications for both clinical practice and clinical research are also included. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Creation of an ensemble of simulated cardiac cases and a human observer study: tools for the development of numerical observers for SPECT myocardial perfusion imaging

NASA Astrophysics Data System (ADS)

O'Connor, J. Michael; Pretorius, P. Hendrik; Gifford, Howard C.; Licho, Robert; Joffe, Samuel; McGuiness, Matthew; Mehurg, Shannon; Zacharias, Michael; Brankov, Jovan G.

2012-02-01

Our previous Single Photon Emission Computed Tomography (SPECT) myocardial perfusion imaging (MPI) research explored the utility of numerical observers. We recently created two hundred and eighty simulated SPECT cardiac cases using Dynamic MCAT (DMCAT) and SIMIND Monte Carlo tools. All simulated cases were then processed with two reconstruction methods: iterative ordered subset expectation maximization (OSEM) and filtered back-projection (FBP). Observer study sets were assembled for both OSEM and FBP methods. Five physicians performed an observer study on one hundred and seventy-nine images from the simulated cases. The observer task was to indicate detection of any myocardial perfusion defect using the American Society of Nuclear Cardiology (ASNC) 17-segment cardiac model and the ASNC five-scale rating guidelines. Human observer Receiver Operating Characteristic (ROC) studies established the guidelines for the subsequent evaluation of numerical model observer (NO) performance. Several NOs were formulated and their performance was compared with the human observer performance. One type of NO was based on evaluation of a cardiac polar map that had been pre-processed using a gradient-magnitude watershed segmentation algorithm. The second type of NO was also based on analysis of a cardiac polar map but with use of a priori calculated average image derived from an ensemble of normal cases.

Comparing masked target transform volume (MTTV) clutter metric to human observer evaluation of visual clutter

NASA Astrophysics Data System (ADS)

Camp, H. A.; Moyer, Steven; Moore, Richard K.

2010-04-01

The Night Vision and Electronic Sensors Directorate's current time-limited search (TLS) model, which makes use of the targeting task performance (TTP) metric to describe image quality, does not explicitly account for the effects of visual clutter on observer performance. The TLS model is currently based on empirical fits to describe human performance for a time of day, spectrum and environment. Incorporating a clutter metric into the TLS model may reduce the number of these empirical fits needed. The masked target transform volume (MTTV) clutter metric has been previously presented and compared to other clutter metrics. Using real infrared imagery of rural images with varying levels of clutter, NVESD is currently evaluating the appropriateness of the MTTV metric. NVESD had twenty subject matter experts (SME) rank the amount of clutter in each scene in a series of pair-wise comparisons. MTTV metric values were calculated and then compared to the SME observers rankings. The MTTV metric ranked the clutter in a similar manner to the SME evaluation, suggesting that the MTTV metric may emulate SME response. This paper is a first step in quantifying clutter and measuring the agreement to subjective human evaluation.

COMPARING THE OBSERVABLE PROPERTIES OF DWARF GALAXIES ON AND OFF THE ANDROMEDA PLANE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Collins, Michelle L. M.; Martin, Nicolas F.; Rich, R. M.

The thin, extended planes of satellite galaxies detected around both the Milky Way and Andromeda are not a natural prediction of the Λ-cold dark matter paradigm. Galaxies in these distinct planes may have formed and evolved in a different way (e.g., tidally) from their off-plane neighbors. If this were the case, one would expect the on- and off-plane dwarf galaxies in Andromeda to have experienced different evolutionary histories, which should be reflected by the chemistries, dynamics, and star formation histories of the two populations. In this work, we present new, robust kinematic observations for two on-plane M31 dwarf spheroidal galaxiesmore » (And XVI and XVII) and compile and compare all available observational metrics for the on- and off-plane dwarfs to search for a signal that would corroborate such a hypothesis. We find that, barring their spatial alignment, the on- and off-plane Andromeda dwarf galaxies are indistinguishable from one another, arguing against vastly different formative and evolutionary histories for these two populations.« less

A Statistical Study of Interplanetary Type II Bursts: STEREO Observations

NASA Astrophysics Data System (ADS)

Krupar, V.; Eastwood, J. P.; Magdalenic, J.; Gopalswamy, N.; Kruparova, O.; Szabo, A.

2017-12-01

Coronal mass ejections (CMEs) are the primary cause of the most severe and disruptive space weather events such as solar energetic particle (SEP) events and geomagnetic storms at Earth. Interplanetary type II bursts are generated via the plasma emission mechanism by energetic electrons accelerated at CME-driven shock waves and hence identify CMEs that potentially cause space weather impact. As CMEs propagate outward from the Sun, radio emissions are generated at progressively at lower frequencies corresponding to a decreasing ambient solar wind plasma density. We have performed a statistical study of 153 interplanetary type II bursts observed by the two STEREO spacecraft between March 2008 and August 2014. These events have been correlated with manually-identified CMEs contained in the Heliospheric Cataloguing, Analysis and Techniques Service (HELCATS) catalogue. Our results confirm that faster CMEs are more likely to produce interplanetary type II radio bursts. We have compared observed frequency drifts with white-light observations to estimate angular deviations of type II burst propagation directions from radial. We have found that interplanetary type II bursts preferably arise from CME flanks. Finally, we discuss a visibility of radio emissions in relation to the CME propagation direction.

Comparative divertor-transport study for helical devices

NASA Astrophysics Data System (ADS)

Feng, Y.; Kobayashi, M.; Sardei, F.; Masuzaki, S.; Kisslinger, J.; Morisaki, T.; Grigull, P.; Yamada, H.; McCormick, K.; Ohyabu, N.; König, R.; Yamada, I.; Giannone, L.; Narihara, K.; Wenzel, U.; Morita, S.; Thomsen, H.; Miyazawa, J.; Hildebrandt, D.; Watanabe, T.; Wagner, F.; Ashikawa, N.; Ida, K.; Komori, A.; Motojima, O.; Nakamura, Y.; Peterson, B. J.; Sato, K.; Shoji, M.; Tamura, N.; Tokitani, M.; LHD experimental Group

2009-09-01

Using the island divertors (IDs) of W7-AS and W7-X and the helical divertor (HD) of LHD as examples, the paper presents a comparative divertor transport study for three typical helical devices of different machine sizes following two distinct divertor concepts, aiming at identifying common physics issues/effects for mutual validation and combined studies. Based on EMC3/EIRENE simulations supported by experimental results, the paper first reviews and compares the essential transport features of the W7-AS ID and the LHD HD in order to build a base and framework for a predictive study of W7-X. The fundamental role of low-order magnetic islands in both divertor concepts is emphasized. Preliminary EMC3/EIRENE simulation results for W7-X are presented and discussed with respect to W7-AS and LHD in order to show how the individual field and divertor topologies affect the divertor transport and performance. For instance, a high recycling regime, which is absent from W7-AS and LHD, is predicted to exist for W7-X. The paper focuses on identifying and understanding the role of divertors for high density plasma operations in helical devices. In this regard, special attention is paid to investigating the divertor function for controlling intrinsic impurities. Impurity transport behaviour and wall-sputtering processes of CX-neutrals are studied under different divertor plasma conditions. A divertor retention effect on intrinsic impurities at high SOL collisonalities is predicted for all the three devices. The required SOL plasma conditions and the underlying mechanisms are analysed in detail. Numerical results are discussed in conjunction with the experimental observations for high density divertor plasmas in W7-AS and LHD. Different SOL transport regimes are numerically identified for the standard divertor configuration of W7-X and the possible consequences on high density plasmas are assessed. All the EMC3-EIRENE simulations presented in this paper are based on vacuum fields

Meta-analyses including data from observational studies.

PubMed

O'Connor, Annette M; Sargeant, Jan M

2014-02-15

Observational studies represent a wide group of studies where the disease or condition of interest is naturally occurring and the investigator does not control allocation to interventions or exposures. Observational studies are used to test hypotheses about the efficacy of interventions or about exposure-disease relationships, to estimate incidence or prevalence of conditions, and to assess the sensitivity and specificity of diagnostic assays. Experimental-study designs and randomized controlled trials (RCTs) can also contribute to the body of evidence about such questions. Meta-analyses (either with or without systematic reviews) aim to combine information from primary research studies to better describe the entire body of work. The aim of meta-analyses may be to obtain a summary effect size, or to understand factors that affect effect sizes. In this paper, we discuss the role of observational studies in meta-analysis questions and some factors to consider when deciding whether a meta-analysis should include results from such studies. Our suggestion is that one should only include studies that are not at high risk of inherent bias when calculating a summary effect size. Study design however can be a meaningful variable in assessment of outcome heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

[Quality analysis of observational studies on pelvic organ prolapse in China].

PubMed

Wang, Y T; Tao, L Y; He, H J; Han, J S

2017-06-25

Objective: To evaluate the quality of observational studies on pelvic organ prolapse in China. Methods: The checklist of strengthening the reporting of observational studies in epidemiology (STROBE) statement was applied to evaluate the observational studies. The articles were searched in the SinoMed database using the terms: prolapse, uterine prolapse, cystocele, rectal prolapse and pelvic floor; limited to Chinese core journals in obstetrics and gynecology from January 1996 to December 2015. With two 10-year groups (1996-2005 and 2006-2015), the χ(2) test was used to evaluate inter-group differences. Results: (1) A total of 386 observational studies were selected, including 15.5%(60/386) of case-control studies, 80.6%(311/386) of cohort studies and 3.9% (15/386) of cross-sectional studies. (2) There were totally 22 items including 34 sub-items in the checklist. There were 17 sub-items (50.0%, 17/34) had a reporting ratio less than 50% in all of aticles, including: 1a (study's design) 3.9% (15/386), 6a (participants) 24.6% (95/386), 6b (matched studies) 0 (0/386), 9 (bias) 8.3% (32/386), 10 (study size) 3.9%, 11 (quantitative variables) 41.2% (159/386), 12b-12e (statistical methods in detail) 0-2.6% (10/386), 13a (numbers of individuals at each stage of study) 18.9% (73/386), 13b (reasons for non-participation at each stage) 18.9%, 13c (flow diagram) 0, 16b and 16c (results of category boundaries and relative risk) 9.6% (37/386) and 0, 19 (limitations) 31.6% (122/386), 22 (funding) 20.5% (79/386). (3) The quality of articles published in the two decades (1996-2005 and 2006-2015) were compared, and 38.2%(13/34) of sub-items had been significantly improved in the second 10-year (all P< 0.05). The improved items were as follows: 1b (integrity of abstract), 2 (background/rationale), 6a (participants), 7 (variables), 8 (data sources/measurement), 9 (bias), 11 (quantitative variables), 12a (statistical methods), 17 (other analyses), 18 (key results), 19 (limitations

A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals.

PubMed

Al-Rawajfah, Omar M; Tubaishat, Ahmad

2017-10-01

The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals. A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode. A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes. This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Conjugated Equine Estrogens and Breast Cancer Risk in the Women’s Health Initiative Clinical Trial and Observational Study

PubMed Central

Prentice, Ross L.; Chlebowski, Rowan T.; Stefanick, Marcia L.; Manson, JoAnn E.; Langer, Robert D.; Pettinger, Mary; Hendrix, Susan L.; Hubbell, F. Allan; Kooperberg, Charles; Kuller, Lewis H.; Lane, Dorothy S.; McTiernan, Anne; O’Sullivan, Mary Jo; Rossouw, Jacques E.; Anderson, Garnet L.

2009-01-01

The Women’s Health Initiative randomized controlled trial found a trend (p = 0.09) toward a lower breast cancer risk among women assigned to daily 0.625-mg conjugated equine estrogens (CEEs) compared with placebo, in contrast to an observational literature that mostly reports a moderate increase in risk with estrogenalone preparations. In 1993–2004 at 40 US clinical centers, breast cancer hazard ratio estimates for this CEE regimen were compared between the Women’s Health Initiative clinical trial and observational study toward understanding this apparent discrepancy and refining hazard ratio estimates. After control for prior use of postmenopausal hormone therapy and for confounding factors, CEE hazard ratio estimates were higher from the observational study compared with the clinical trial by 43% (p = 0.12). However, after additional control for time from menopause to first use of postmenopausal hormone therapy, the hazard ratios agreed closely between the two cohorts (p = 0.82). For women who begin use soon after menopause, combined analyses of clinical trial and observational study data do not provide clear evidence of either an overall reduction or an increase in breast cancer risk with CEEs, although hazard ratios appeared to be relatively higher among women having certain breast cancer risk factors or a low body mass index. PMID:18448442

Mid-Infrared Observational and Theoretical Studies of Star Formation and Early Solar Systems

NASA Technical Reports Server (NTRS)

Jones, Barbara

1997-01-01

The first 2 years of this program were used to make mid-IR observations of regions of star formation in the Orion nebula with the UCSD mid-IR camera at the UCSD/University of Minnesota telescope at Mt. Lemmon. These observations attempted to make the first systematic study of an extended region, known to have newly forming stars, and expected to have complex mid-IR emission. We discovered, to our surprise, that most of the thermal emission originated from extended sources rather than from point sources. This interesting observation made the analysis of the data much more complex, since the chop/nod procedures used at these wavelengths produce a differential measurement of the emission in one region compared to that in the adjacent region. Disentangling complex extended emission in such a situation is very difficult. In parallel with this work we were also observing comets in the thermal infrared, the other component of the original proposal. Some spectacular data on the comet Swift-Tuttle was acquired and published. A changing jet structure observed over a 2 week period is described. The rotation period of the comet can be measured at 66 hours. The size of the nucleus can also be estimated (at 30 km) from the observed excess flux from the nucleus. These data have lead to the development of models describing the action of dust particles of differing sizes and composition leaving the nucleus. The spatial distribution of the predicted IR emission has been compared to the observed jet structures, leading to estimates of both particles sizes, relative amounts of silicate vs organic grains, and the amounts of dust emitted in the jets vs isotopic emission.

Late onset rheumatoid arthritis an observational study.

PubMed

Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Rexhepi, Blerta; Bahtiri, Elton; Mahmutaj, Vigan

Rheumatoid arthritis (RA) may have an onset at older age. The onset of the disease at the age of 60 and over is called late-onset rheumatoid arthritis (LORA). The aim of this study was to analyze the clinical, laboratory, radiological, and treatment characteristics of patients with LORA compared to those with early-onset RA (EaORA), provided that all the patients had an approximately equal duration of the disease. This is an observational single-center study, which involved 120 patients with an established diagnosis of RA, of which 60 patients had LORA, and 60 patients EaORA. The disease activity, measured by the Disease Activity Score 28 (DAS28-ESR), was significantly higher in the LORA group compared to the EaORA group (p<0.05). Significantly more patients with LORA had involvement of the shoulders (LORA vs. EaORA, 30% vs. 15%; p <0.05) and knees (LORA vs. EaORA, 46.7% vs. 16.7%; p <0.05). Radiological erosive changes were significantly more frequent in the LORA group in comparison with EaORA (p <0.05). There was no difference between the groups regarding rheumatoid factor (RF) positivity (p>0.05), while the number of patients positive for anti-citrullinated protein antibody (ACPA) was signifi cantly greater in the EaORA group (p<0.05). The values of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly higher in the LORA than in the EaORA group. Hemoglobin levels were lower in the LORA group (11.96±1.64 g/dL) than in the EaORA group (12.18±1.56 g/dL). The most used disease-modifying antirheumatic drugs (DMARDs) were methotrexate and sulfasalazine, while biological drugs were not used. In conclusion, based on the results of our study, LORA has some features that distinguish it from EaORA, such as higher disease activity, more frequent involvement of large joints, and more pronounced structural damage. This should be taken in account in clinical practice, especially regarding treatment choices.

Immortal time bias in observational studies of time-to-event outcomes.

PubMed

Jones, Mark; Fowler, Robert

2016-12-01

The purpose of the study is to show, through simulation and example, the magnitude and direction of immortal time bias when an inappropriate analysis is used. We compare 4 methods of analysis for observational studies of time-to-event outcomes: logistic regression, standard Cox model, landmark analysis, and time-dependent Cox model using an example data set of patients critically ill with influenza and a simulation study. For the example data set, logistic regression, standard Cox model, and landmark analysis all showed some evidence that treatment with oseltamivir provides protection from mortality in patients critically ill with influenza. However, when the time-dependent nature of treatment exposure is taken account of using a time-dependent Cox model, there is no longer evidence of a protective effect of treatment. The simulation study showed that, under various scenarios, the time-dependent Cox model consistently provides unbiased treatment effect estimates, whereas standard Cox model leads to bias in favor of treatment. Logistic regression and landmark analysis may also lead to bias. To minimize the risk of immortal time bias in observational studies of survival outcomes, we strongly suggest time-dependent exposures be included as time-dependent variables in hazard-based analyses. Copyright © 2016 Elsevier Inc. All rights reserved.

Cellular transplants in amyotrophic lateral sclerosis patients: an observational study.

PubMed

Gamez, Josep; Carmona, Francesc; Raguer, Nuria; Ferrer-Sancho, Jaume; Martín-Henao, Gregorio A; Martí-Beltrán, Sergi; Badia, Merce; Gratacós, Margarita; Rodriguez-Gónzalez, Esther; Seoane, Jose Luis; Pallero-Castillo, Mercedes; Burgos, Rosa; Puiggros, Carolina; Pasarin, Alejandro; Bori-Fortuny, Inmaculada

2010-09-01

Cytotherapy is a promising option for neurodegenerative disease treatment. Because of the fatal prognosis and imperative need for effective treatment, amyotrophic lateral sclerosis (ALS) patients request this therapy before its effectiveness has been verified. The increase in clinics offering cytotherapies but providing little scientific information has prompted considerable medical tourism. We present an observational study of Spanish ALS patients receiving cytotherapy, analyzing the experiences arising from the treatment (TX) and considering two progression markers, FVC and ALSFRS-R. Twelve ALS patients with a mean age of 48.6 years (SD 12.8) received cytotherapy 26.9 months (SD 15.8) after clinical onset. ALSFRS-R and FVC at TX were 32.3 (SD 6.8) and 63.4% (SD 15.3), respectively. TX involved transplants of olfactory ensheathing cells in three patients, and autologous mesenchymal stromal cells in the remainder. One patient died 33 months post-TX after surviving for 49 months. Five required mechanical non-invasive home ventilation 7.4 months post-TX. Two required invasive ventilation 13 months post-TX. Five patients needed gastrostomy feeding 23.3 months post-TX. Survival between clinical onset and the study end date was 50 months (SD 17.2). No significant adverse events or changes in the decline of FVC and ALSFRS-R compared with the disease's natural history were observed. Our observations suggest that these therapies do not halt the course of the disease. Cytotherapy cannot yet be considered a curative treatment for ALS.

Discrepancy between results and abstract conclusions in industry- vs nonindustry-funded studies comparing topical prostaglandins.

PubMed

Alasbali, Tariq; Smith, Michael; Geffen, Noa; Trope, Graham E; Flanagan, John G; Jin, Yaping; Buys, Yvonne M

2009-01-01

To investigate the relationship between industry- vs nonindustry-funded publications comparing the efficacy of topical prostaglandin analogs by evaluating the correspondence between the statistical significance of the publication's main outcome measure and its abstract conclusions. Retrospective, observational cohort study. English publications comparing the ocular hypotensive efficacy between any or all of latanoprost, travoprost, and bimatoprost were searched from the MEDLINE database. Each article was reviewed by three independent observers and was evaluated for source of funding, study quality, statistically significant main outcome measure, correspondence between results of main outcome measure and abstract conclusion, number of intraocular pressure outcomes compared, and journal impact factor. Funding was determined by published disclosure or, in cases of no documented disclosure, the corresponding author was contacted directly to confirm industry funding. Discrepancies were resolved by consensus. The main outcome measure was correspondence between abstract conclusion and reported statistical significance of the publications' main outcome measure. Thirty-nine publications were included, of which 29 were industry funded and 10 were nonindustry funded. The published abstract conclusion was not consistent with the results of the main outcome measure in 18 (62%) of 29 of the industry-funded studies compared with zero (0%) of 10 of the nonindustry-funded studies (P = .0006). Twenty-six (90%) of the industry-funded studies had proindustry abstract conclusions. Twenty-four percent of the industry-funded publications had a statistically significant main outcome measure; however, 90% of the industry-funded studies had proindustry abstract conclusions. Both readers and reviewers should scrutinize publications carefully to ensure that data support the authors' conclusions.

Comparative study of electrical breakdown properties of deionized water and heavy water under pulsed power conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Veda Prakash, G.; Kumar, R.; Saurabh, K.

A comparative study of electrical breakdown properties of deionized water (H{sub 2}O) and heavy water (D{sub 2}O) is presented with two different electrode materials (stainless steel (SS) and brass) and polarity (positive and negative) combinations. The pulsed (∼a few tens of nanoseconds) discharges are conducted by applying high voltage (∼a few hundred kV) pulse between two hemisphere electrodes of the same material, spaced 3 mm apart, at room temperature (∼26-28 °C) with the help of Tesla based pulse generator. It is observed that breakdown occurred in heavy water at lesser voltage and in short duration compared to deionized water irrespective ofmore » the electrode material and applied voltage polarity chosen. SS electrodes are seen to perform better in terms of the voltage withstanding capacity of the liquid dielectric as compared to brass electrodes. Further, discharges with negative polarity are found to give slightly enhanced discharge breakdown voltage when compared with those with positive polarity. The observations corroborate well with conductivity measurements carried out on original and post-treated liquid samples. An interpretation of the observations is attempted using Fourier transform infrared measurements on original and post-treated liquids as well as in situ emission spectra studies. A yet another important observation from the emission spectra has been that even short (nanosecond) duration discharges result in the formation of a considerable amount of ions injected into the liquid from the electrodes in a similar manner as reported for long (microseconds) discharges. The experimental observations show that deionised water is better suited for high voltage applications and also offer a comparison of the discharge behaviour with different electrodes and polarities.« less

Observational studies of roAp stars

NASA Astrophysics Data System (ADS)

Sachkov, M.

2014-11-01

Rapidly oscillating Ap (roAp) stars are high-overtone, low-degree p-mode pulsators that are also chemically peculiar magnetic A stars. Until recently the classical asteroseismic analysis i.e. frequency analysis, of these stars was based on ground and space photometric observations. Significant progress was achieved through access to uninterrupted, ultra-high-precision data from MOST, COROT and Kepler satellites. Over the last ten years the study of roAp stars has been altered drastically from an observational point of view through studies of time-resolved, high-resolution spectra. Their unusual pulsational characteristics, caused by an interplay between the short vertical lengths of the pulsation waves and strong stratification of chemical elements, allow us to examine the upper roAp atmosphere in more detail than is possible for any star except the Sun. In this paper I review the results of recent studies of the pulsations of roAp stars.

Many participants in inpatient rehabilitation can quantify their exercise dosage accurately: an observational study.

PubMed

Scrivener, Katharine; Sherrington, Catherine; Schurr, Karl; Treacy, Daniel

2011-01-01

Are inpatients undergoing rehabilitation who appear able to count exercises able to quantify accurately the amount of exercise they undertake? Observational study. Inpatients in an aged care rehabilitation unit and a neurological rehabilitation unit, who appeared able to count their exercises during a 1-2 min observation by their treating physiotherapist. Participants were observed for 30 min by an external observer while they exercised in the physiotherapy gymnasium. Both the participants and the observer counted exercise repetitions with a hand-held tally counter and the two tallies were compared. Of the 60 people admitted for aged care rehabilitation during the study period, 49 (82%) were judged by their treating therapist to be able to count their own exercise repetitions accurately. Of the 30 people admitted for neurological rehabilitation during the study period, 20 (67%) were judged by their treating therapist to be able to count their repetitions accurately. Of the 69 people judged to be accurate, 40 underwent observation while exercising. There was excellent agreement between these participants' counts of their exercise repetitions and the observers' counts, ICC (3,1) of 0.99 (95% CI 0.98 to 0.99). Eleven participants (28%) were in complete agreement with the observer. A further 19 participants (48%) varied from the observer by less than 10%. Therapists were able to identify a group of rehabilitation participants who were accurate in counting their exercise repetitions. Counting of exercise repetitions by therapist-selected patients is a valid means of quantifying exercise dosage during inpatient rehabilitation. Copyright © 2011 Australian Physiotherapy Association. Published by .. All rights reserved.

Performance Evaluation of New-Generation Pulse Oximeters in the NICU: Observational Study.

PubMed

Nizami, Shermeen; Greenwood, Kim; Barrowman, Nick; Harrold, JoAnn

2015-09-01

This crossover observational study compares the data characteristics and performance of new-generation Nellcor OXIMAX and Masimo SET SmartPod pulse oximeter technologies. The study was conducted independent of either original equipment manufacturer (OEM) across eleven preterm infants in a Neonatal Intensive Care Unit (NICU). The SmartPods were integrated with Dräger Infinity Delta monitors. The Delta monitor measured the heart rate (HR) using an independent electrocardiogram sensor, and the two SmartPods collected arterial oxygen saturation (SpO2) and pulse rate (PR). All patient data were non-Gaussian. Nellcor PR showed a higher correlation with the HR as compared to Masimo PR. The statistically significant difference found in their median values (1% for SpO2, 1 bpm for PR) was deemed clinically insignificant. SpO2 alarms generated by both SmartPods were observed and categorized for performance evaluation. Results for sensitivity, positive predictive value, accuracy and false alarm rates were Nellcor (80.3, 50, 44.5, 50%) and Masimo (72.2, 48.2, 40.6, 51.8%) respectively. These metrics were not statistically significantly different between the two pulse oximeters. Despite claims by OEMs, both pulse oximeters exhibited high false alarm rates, with no statistically or clinically significant difference in performance. These findings have a direct impact on alarm fatigue in the NICU. Performance evaluation studies can also impact medical device purchase decisions made by hospital administrators.

System study of the carbon dioxide observational platform system (CO-OPS): Project overview

NASA Technical Reports Server (NTRS)

Stephens, J. Briscoe; Thompson, Wilbur E.

1987-01-01

The resulting options from a system study for a near-space, geo-stationary, observational monitoring platform system for use in the Department of Energy's (DOE) National Carbon Dioxide Observational Platform System (CO-OPS) on the greenhouse effect are discussed. CO-OPS is being designed to operate continuously for periods of up to 3 months in quasi-fixed position over most global regional targets of interest and could make horizon observations over a land-sea area of circular diameter up to about 600 to 800 statute miles. This affords the scientific and engineering community a low-cost means of operating their payloads for monitoring the regional parameters they deem relevant to their investigations of the carbon dioxide greenhouse effect at one-tenth the cost of most currently utilized comparable remote sensing techniques.

Does topical wound oxygen (TWO2) offer an improved outcome over conventional compression dressings (CCD) in the management of refractory venous ulcers (RVU)? A parallel observational comparative study.

PubMed

Tawfick, W; Sultan, S

2009-07-01

Topical wound oxygen (TWO(2)) may help wound healing in the management of refractory venous ulcers (RVU). The aim of this study was to measure the effect of TWO(2) on wound healing using the primary end-point of the proportion of ulcers healed at 12 weeks. Secondary end-points were time to full healing, percentage of reduction in ulcer size, pain reduction, recurrence rates and Quality-Adjusted Time Spent Without Symptoms of disease and Toxicity of Treatment (Q-TWiST). A parallel observational comparative study. Patients with CEAP C(6,s) RVU, assessed by duplex ultrasonography, were managed with either TWO(2) (n=46) or conventional compression dressings (CCD) (n=37) for 12 weeks or till full healing. Patients were followed up at 3 monthly intervals. At 12 weeks, 80% of TWO(2) managed ulcers were completely healed, compared to 35% of CCD ulcers (p<0.0001). Median time to full healing was 45 days in TWO(2) patients and 182 days in CCD patients (p<0.0001). The pain score threshold in TWO(2) managed patients improved from 8 to 3 by 13 days. After 12-month follow-up, 5 of the 13 healed CCD ulcers showed signs of recurrence compared to none of the 37 TWO(2) healed ulcers. TWO(2) patients experienced a significantly improved Q-TWiST. TWO(2) reduces recurrence rates, alleviates pain and improves the Q-TWiST. We believe it is a valuable tool in the armamentarium of management of RVU.

Observational studies are complementary to randomized controlled trials.

PubMed

Grootendorst, Diana C; Jager, Kitty J; Zoccali, Carmine; Dekker, Friedo W

2010-01-01

Randomized controlled trials (RCTs) are considered the gold standard study design to investigate the effect of health interventions, including treatment. However, in some situations, it may be unnecessary, inappropriate, impossible, or inadequate to perform an RCT. In these special situations, well-designed observational studies, including cohort and case-control studies, may provide an alternative to doing nothing in order to obtain estimates of treatment effect. It should be noted that such studies should be performed with caution and correctly. The aims of this review are (1) to explain why RCTs are considered the optimal study design to evaluate treatment effects, (2) to describe the situations in which an RCT is not possible and observational studies are an adequate alternative, and (3) to explain when randomization is not needed and can be approximated in observational studies. Examples from the nephrology literature are used for illustration. Copyright 2009 S. Karger AG, Basel.

Comparative study of infection with Tetrahymena of different ornamental fish species.

PubMed

Sharon, G; Pimenta Leibowitz, M; Chettri, J Kumar; Isakov, N; Zilberg, D

2014-01-01

Tetrahymena is a ciliated protozoan that can infect a wide range of fish species, although it is most commonly reported in guppies (Poecilia reticulata). The aim of this study was to compare the susceptibility to infection with Tetrahymena of five different ornamental fish species from two different super orders. The species examined were platy (Xiphophorus), molly (Poecilia sphenops) and angelfish (Pterophyllum scalare) of the Acanthopterygii super order (which also includes guppies) and goldfish (Carassius auratus auratus) and koi carp (Cyprinus carpio) of the Ostariophysi super order. These two super orders are phylogenetically distant from each other. Infection with Tetrahymena resulted in parasite invasion of internal organs, skin and muscle in all fish species. A relatively strong inflammatory response was observed in infected goldfish and koi, with negligible response in fish species of the Acanthopterygii super order. Guppies were the most susceptible to Tetrahymena infection, exhibiting a mortality rate of 87% and 100% in two separate experiments. A high mortality rate was also observed in platy (77%), while that of molly and angelfish was significantly lower (23% and 33%, respectively). Goldfish and koi carp were less susceptible to infection compared with guppies (24% and 59% mortality, respectively). Immunization studies revealed that the Tetrahymena are immunogenic, since infection of koi carp increased their Tetrahymena immobilization response by approximately three-fold at 3 weeks post infection, while immunization with Tetrahymena plus adjuvant increased their immobilization response by approximately 30-fold. Copyright © 2013 Elsevier Ltd. All rights reserved.

Observer assessment of multi-pinhole SPECT geometries for prostate cancer imaging: a simulation study

NASA Astrophysics Data System (ADS)

Kalantari, Faraz; Sen, Anando; Gifford, Howard C.

2014-03-01

SPECT imaging using In-111 ProstaScint is an FDA-approved method for diagnosing prostate cancer metastases within the pelvis. However, conventional medium-energy parallel-hole (MEPAR) collimators produce poor image quality and we are investigating the use of multipinhole (MPH) imaging as an alternative. This paper presents a method for evaluating MPH designs that makes use of sampling-sensitive (SS) mathematical model observers for tumor detectionlocalization tasks. Key to our approach is the redefinition of a normal (or background) reference image that is used with scanning model observers. We used this approach to compare different MPH configurations for the task of small-tumor detection in the prostate and surrounding lymph nodes. Four configurations used 10, 20, 30, and 60 pinholes evenly spaced over a complete circular orbit. A fixed-count acquisition protocol was assumed. Spherical tumors were placed within a digital anthropomorphic phantom having a realistic Prostascint biodistribution. Imaging data sets were generated with an analytical projector and reconstructed volumes were obtained with the OSEM algorithm. The MPH configurations were compared in a localization ROC (LROC) study with 2D pelvic images and both human and model observers. Regular and SS versions of the scanning channelized nonprewhitening (CNPW) and visual-search (VS) model observers were applied. The SS models demonstrated the highest correlations with the average human-observer results

An observational study comparing continuous subcutaneous insulin infusion (CSII) and insulin glargine in children with type 1 diabetes.

PubMed

Schiaffini, Riccardo; Ciampalini, Paolo; Spera, Sabrina; Cappa, Marco; Crinó, Antonino

2005-01-01

The advantages of continuous subcutaneous insulin infusion (CSII) or insulin glargine have been demonstrated both in adult and paediatric diabetic patients; however, as no data comparing these two approaches during childhood are available, we have examined the efficacy of these two intensive approaches. We retrospectively evaluated data from 36 diabetic children, who had changed their previous insulin regimen [with isophane insulin (NPH) at bedtime] because of HbA1c levels >8.0%. Twenty patients underwent CSII, while the other 16 (significantly younger for age) started insulin glargine at bedtime. At 6 and 12 months, CSII-treated patients showed a significant reduction in HbA1c values from 8.5 +/- 1.8 to 7.4 +/- 1.1% and to 7.6 +/- 1.2%, respectively. The insulin requirement significantly decreased from 0.93 +/- 0.2 IU/kg to 0.73 +/- 0.2 IU/kg of body weight and to 0.74 +/- 0.15 IU/kg of body weight, respectively, while no significant differences were observed for BMI SDS, fructosamine and severe hypoglycaemic events. The patients treated with glargine showed a small decline in HbA1c values from 8.9 +/- 1.7 to 8.3 +/- 0.9% (not significant) in the first 6 months of treatment and to 8.2 +/- 0.9% after 12 months. The basal insulin supplementation can be supplied effectively in children with type 1 diabetes by either CSII or insulin glargine. As previously reported for adults, it is confirmed that CSII is the best current intensive approach aimed to the improvement of glycaemic control.

Comparing NEXRAD Operational Precipitation Estimates and Raingage Observations of Intense Precipitation in the Missouri River Basin.

NASA Astrophysics Data System (ADS)

Young, C. B.

2002-05-01

Accurate observation of precipitation is critical to the study and modeling of land surface hydrologic processes. NEXRAD radar-based precipitation estimates are increasingly used in field experiments, hydrologic modeling, and water and energy budget studies due to their high spatial and temporal resolution, national coverage, and perceived accuracy. Extensive development and testing of NEXRAD precipitation algorithms have been carried out in the Southern Plains. Previous studies (Young et al. 2000, Young et al. 1999, Smith et al. 1996) indicate that NEXRAD operational products tend to underestimate precipitation at light rain rates. This study investigates the performance of NEXRAD precipitation estimates of high-intensity rainfall, focusing on flood-producing storms in the Missouri River Basin. NEXRAD estimates for these storms are compared with data from multiple raingage networks, including NWS recording and non-recording gages and ALERT raingage data for the Kansas City metropolitan area. Analyses include comparisons of gage and radar data at a wide range of temporal and spatial scales. Particular attention is paid to the October 4th, 1998, storm that produced severe flooding in Kansas City. NOTE: The phrase `NEXRAD operational products' in this abstract includes precipitation estimates generated using the Stage III and P1 algorithms. Both of these products estimate hourly accumulations on the (approximately) 4 km HRAP grid.

Properties of the circumgalactic medium in simulations compared to observations

NASA Astrophysics Data System (ADS)

Machado, R. E. G.; Tissera, P. B.; Lima Neto, G. B.; Sodré, L.

2018-01-01

Context. Galaxies are surrounded by extended gaseous halos that store significant fractions of chemical elements. These are syntethized by the stellar populations and later ejected into the circumgalactic medium (CGM) by different mechanism, of which supernova feedback is considered one of the most relevant. Aims: We aim to explore the properties of this metal reservoir surrounding star-forming galaxies in a cosmological context aiming to investigate the chemical loop between galaxies and their CGM, and the ability of the subgrid models to reproduce observational results. Methods: Using cosmological hydrodynamical simulations, we have analysed the gas-phase chemical contents of galaxies with stellar masses in the range 109-1011 M⊙. We estimated the fractions of metals stored in the different CGM phases, and the predicted O VI and Si III column densities within the virial radius. Results: We find roughly 107 M⊙ of oxygen in the CGM of simulated galaxies having M⋆ 1010 M⊙, in fair agreement with the lower limits imposed by observations. The Moxy is found to correlate with M⋆, at odds with current observational trends but in agreement with other numerical results. The estimated profiles of O VI column density reveal a substantial shortage of that ion, whereas Si III, which probes the cool phase, is overpredicted. Nevertheless, the radial dependences of both ions follow the respective observed profiles. The analysis of the relative contributions of both ions from the hot, warm and cool phases suggests that the warm gas (105 K < T < 106 K) should be more abundant in order to bridge the mismatch with the observations, or alternatively, that more metals should be stored in this gas-phase. These discrepancies provide important information to improve the subgrid physics models. Our findings show clearly the importance of tracking more than one chemical element and the difficulty of simultaneously satisfying the observables that trace the circumgalactic gas at

Observer-rated coping associated with borderline personality disorder: an exploratory study.

PubMed

Kramer, Ueli

2014-01-01

Little is known about coping specificities, as operationalization of the concept of affect regulation, in borderline personality disorder (BPD). It is most important to take into account methodological criticisms addressed to the self-report questionnaire approach and to compare BPD coping specificities to the ones of neighbouring diagnostic categories, such as bipolar disorder (BD). The present exploratory study compared the coping profiles of N = 25 patients presenting BPD to those of N = 25 patients presenting BD and to those of N = 25 healthy controls. All participants underwent a clinical interview that was transcribed and rated using the Coping Patterns observer-rater system. Results partially confirmed study hypotheses and showed differences between BPD patients and healthy controls in all coping domains (competence, resources and autonomy), whereas the only coping domain presenting a BPD-specific lack of skills, compared with the BD patients, was autonomy, a set of coping strategies facing stress appraised as challenge. These coping processes were linked to general and BPD symptomatology. These results extend conclusions of earlier studies on affect regulation processes in BPD and bear important clinical implications, in the context of dialectical behavior therapy and other therapeutic approaches. Limitations of this exploratory study, such as the small sample size, are acknowledged. Coping can be reliably assessed in the narrative process in an non-structured interview frame. Patients with borderline personality disorder present with a specific lack of skills in affect regulation related to autonomy issues, compared to patients with bipolar disorder and healthy controls. Lack of skills in accommodation to distressing emotions in borderline personality disorder is related to symptom gravity and may be treated using radical acceptance strategies. Copyright © 2012 John Wiley & Sons, Ltd.

Sulfonylureas and the Risks of Cardiovascular Events and Death: A Methodological Meta-Regression Analysis of the Observational Studies.

PubMed

Azoulay, Laurent; Suissa, Samy

2017-05-01

Recent randomized trials have compared the newer antidiabetic agents to treatments involving sulfonylureas, drugs associated with increased cardiovascular risks and mortality in some observational studies with conflicting results. We reviewed the methodology of these observational studies by searching MEDLINE from inception to December 2015 for all studies of the association between sulfonylureas and cardiovascular events or mortality. Each study was appraised with respect to the comparator, the outcome, and study design-related sources of bias. A meta-regression analysis was used to evaluate heterogeneity. A total of 19 studies were identified, of which six had no major design-related biases. Sulfonylureas were associated with an increased risk of cardiovascular events and mortality in five of these studies (relative risks 1.16-1.55). Overall, the 19 studies resulted in 36 relative risks as some studies assessed multiple outcomes or comparators. Of the 36 analyses, metformin was the comparator in 27 (75%) and death was the outcome in 24 (67%). The relative risk was higher by 13% when the comparator was metformin, by 20% when death was the outcome, and by 7% when the studies had design-related biases. The lowest predicted relative risk was for studies with no major bias, comparator other than metformin, and cardiovascular outcome (1.06 [95% CI 0.92-1.23]), whereas the highest was for studies with bias, metformin comparator, and mortality outcome (1.53 [95% CI 1.43-1.65]). In summary, sulfonylureas were associated with an increased risk of cardiovascular events and mortality in the majority of studies with no major design-related biases. Among studies with important biases, the association varied significantly with respect to the comparator, the outcome, and the type of bias. With the introduction of new antidiabetic drugs, the use of appropriate design and analytical tools will provide their more accurate cardiovascular safety assessment in the real-world setting

Comparing the TYCHO Catalogue with CCD Astrograph Observations

NASA Astrophysics Data System (ADS)

Zacharias, N.; Hoeg, E.; Urban, S. E.; Corbin, T. E.

1997-08-01

Selected fields around radio-optical reference frame sources have been observed with the U.S. Naval Observatory CCD astrograph (UCA). This telescope is equipped with a red-corrected 206mm 5-element lens and a 4k by 4k CCD camera which provides a 1 square degree field of view. Positions with internal precisions of 20 mas for stars in the 7 to 12 magnitude range have been obtained with 30 second exposures. A comparison is made with the Tycho Catalogue, which is accurate to about 5 to 50 mas at mean epoch of J1991.25, depending on the magnitude of the star. Preliminary proper motions are obtained using the Astrographic Catalogue (AC) to update the Tycho positions to the epoch of the UCA observations, which adds an error contribution of about 15 to 20 mas. Individual CCD frames have been reduced with an average of 30 Tycho reference stars per frame. A linear plate model gives an average adjustment standard error of 46 mas, consistent with the internal errors. The UCA is capable of significantly improving the positions of Tycho stars fainter than about visual magnitude 9.5.

Comparison between treatment effects in a randomised controlled trial and an observational study using propensity scores in primary care.

PubMed

Stuart, Beth L; Grebel, Louise En; Butler, Christopher C; Hood, Kerenza; Verheij, Theo J M; Little, Paul

2017-09-01

Although randomised controlled trials (RCTs) are considered 'gold standard' evidence, they are not always feasible or appropriate, and may represent a select population. Observational studies provide a useful alternative to enhance applicability, but results can be biased due to confounding. To explore the utility of propensity scores for causal inference in an observational study. Comparison of the effect of amoxicillin on key outcomes in an international RCT and observational study of lower respiratory tract infections. Propensity scores were calculated and applied as probability weights in the analyses. The adjusted results were compared with the effects reported in the RCT. Groups were well balanced in the RCT but significantly imbalanced in the observational study, with evidence of confounding by indication: patients receiving antibiotics tended to be older and more unwell at baseline consultation. In the trial duration of symptoms (hazard ratio 1.06, 95% CI = 0.96 to 1.18) and symptom severity (-0.07, 95% CI = -0.15 to 0.007) did not differ between groups. Weighting by propensity score in the observational study resulted in very similar estimates of effect: duration of symptoms (hazard ratio 1.06, 95% CI = 0.80 to 1.40) and difference for symptom severity (-0.07, 95% CI = -0.34 to 0.20). The observational study, after conditioning on propensity score, echoed the trial results. Provided that detailed information is available on potential sources of confounding, effects of interventions can probably be assessed reasonably well in observational datasets, allowing them to be more directly compared with the results of RCTs. © British Journal of General Practice 2017.

Radiology workstation for mammography: preliminary observations, eyetracker studies, and design

NASA Astrophysics Data System (ADS)

Beard, David V.; Johnston, Richard E.; Pisano, Etta D.; Hemminger, Bradley M.; Pizer, Stephen M.

1991-07-01

For the last four years, the UNC FilmPlane project has focused on constructing a radiology workstation facilitating CT interpretations equivalent to those with film and viewbox. Interpretation of multiple CT studies was originally chosen because handling such large numbers of images was considered to be one of the most difficult tasks that could be performed with a workstation. The authors extend the FilmPlane design to address mammography. The high resolution and contrast demands coupled with the number of images often cross- compared make mammography a difficult challenge for the workstation designer. This paper presents the results of preliminary work with workstation interpretation of mammography. Background material is presented to justify why the authors believe electronic mammographic workstations could improve health care delivery. The results of several observation sessions and a preliminary eyetracker study of multiple-study mammography interpretations are described. Finally, tentative conclusions of what a mammographic workstation might look like and how it would meet clinical demand to be effective are presented.

The influence of comorbidities on mortality in sarcoidosis: a observational prospective cohort study.

PubMed

Nowiński, Adam; Puścińska, Elzbieta; Goljan, Anna; Peradzynska, Joanna; Bednarek, Michal; Korzybski, Damian; Kamiński, Dariusz; Stokłosa, Anna; Czystowska, Monika; Śliwiński, Pawel; Górecka, Dorota

2017-09-01

The aim of this study was to identify the frequency and prevalence of comorbidities in sarcoid patients and to assess their influence on overall mortality in the cohort of patients with sarcoidosis. A cohort of 557 patients with histologically confirmed sarcoidosis diagnosed between 2007 and 2011 and a group of non-sarcoid controls were observed. All patients were carefully observed for comorbidities and mortality. 291 males (52.2%) and 266 females (47.8%) with mean age 48.4 ± 12.0 years in sarcoidosis group and a group of 100 controls with mean age (49.25 ± 10.3) were observed. The mean number of comorbidities in both groups was similar (0.9 ± 0.99 vs 0.81 ± 0.84 NS). The frequency of thyroid disease was significantly higher in sarcoidosis group comparing to controls at the time of diagnosis (OR = 3.62 P = 0.0144). During the observation period (median 58.0 months), 16 patients died (2.9%). The mean number of comorbidities was significantly higher in the groups of non-survivors as compared to survivors (2.8 ± 1.0, vs 0.8 ± 0.9), P < 0.0001. The comorbidity burden has strong impact on mortality in sarcoidosis. Thyroid diseases are more frequent in sarcoidosis than in non-sarcoid controls. © 2015 John Wiley & Sons Ltd.

Assessment of Root Resorption and Root Shape by Periapical and Panoramic Radiographs: A Comparative Study.

PubMed

Ahuja, Puneeta D; Mhaske, Sheetal P; Mishra, Gaurav; Bhardwaj, Atul; Dwivedi, Ruby; Mangalekar, Sachin B

2017-06-01

One of the common findings encountered by the clinician at the end of orthodontic treatment is the apical root resorption. Root resorption occurs to various degrees. A severe form of root resorption is characterized by shortening of root for more than 4 mm or more than one-third of the total tooth length. A low incidence rate of resorption is observed based on radiographic findings for the diagnosis of root resorption, panoramic radiography, and periapical radiography. Hence, we evaluated the accuracy of panoramic radiographic films for assessing the root resorption in comparison with the periapical films. This study included the assessment of all the cases in which pre- and post-treatment radiographs were available for analysis of the assessment of the amount of root resorption. Complete records of 80 patients were analyzed. Examination of a total of 900 teeth was done. Mean age of the patients in this study was 21 years ranging from 11 to 38 years. The majority of the patients in the present study were females. All the treatments were carried out by registered experienced orthodontists having minimum experience of more than 10 years. All the cases were divided into two study groups. Group I comprised panoramic radiographic findings, while group II consisted of periapical radiographic findings. For the measurement of crown portion, root portion, and the complete root length, magnification loops of over 100 powers with parallax correction with inbuilt grids were used. Assessment of the tooth length and the crown length was done by the same observers. All the results were analyzed by Statistical Package for the Social Sciences software version 6.0. Maximum amount of root resorption was observed in case of maxillary central incisors and canines among group I and II cases respectively. However, nonsignificant difference was obtained while comparing the mean root resorption in relation to maxillary incisors and canines among the two study groups. While comparing the

Prospective clinical observational study evaluating gender-associated differences of preoperative pain intensity.

PubMed

Tafelski, Sascha; Kerper, Léonie F; Salz, Anna-Lena; Spies, Claudia; Reuter, Eva; Nachtigall, Irit; Schäfer, Michael; Krannich, Alexander; Krampe, Henning

2016-07-01

Previous studies reported conflicting results concerning different pain perceptions of men and women. Recent research found higher pain levels in men after major surgery, contrasted by women after minor procedures. This trial investigates differences in self-reported preoperative pain intensity between genders before surgery.Patients were enrolled in 2011 and 2012 presenting for preoperative evaluation at the anesthesiological assessment clinic at Charité University hospital. Out of 5102 patients completing a computer-assisted self-assessment, 3042 surgical patients with any preoperative pain were included into this prospective observational clinical study. Preoperative pain intensity (0-100 VAS, visual analog scale) was evaluated integrating psychological cofactors into analysis.Women reported higher preoperative pain intensity than men with median VAS scores of 30 (25th-75th percentiles: 10-52) versus 21 (10-46) (P < 0.001). Adjusted multiple regression analysis showed that female gender remained statistically significantly associated with higher pain intensity (P < 0.001). Gender differences were consistent across several subgroups especially with varying patterns in elderly. Women scheduled for minor and moderate surgical procedures showed largest differences in overall pain compared to men.This large clinical study observed significantly higher preoperative pain intensity in female surgical patients. This gender difference was larger in the elderly potentially contradicting the current hypothesis of a primary sex-hormone derived effect. The observed variability in specific patient subgroups may help to explain heterogeneous findings of previous studies.

Continuing Studies in Support of Ultraviolet Observations of Planetary Atmospheres

NASA Technical Reports Server (NTRS)

Clark, John

1997-01-01

This program was a one-year extension of an earlier Planetary Atmospheres program grant, covering the period 1 August 1996 through 30 September 1997. The grant was for supporting work to complement an active program observing planetary atmospheres with Earth-orbital telescopes, principally the Hubble Space Telescope (HST). The recent concentration of this work has been on HST observations of Jupiter's upper atmosphere and aurora, but it has also included observations of Io, serendipitous observations of asteroids, and observations of the velocity structure in the interplanetary medium. The observations of Jupiter have been at vacuum ultraviolet wavelengths, including imaging and spectroscopy of the auroral and airglow emissions. The most recent HST observations have been at the same time as in situ measurements made by the Galileo orbiter instruments, as reflected in the meeting presentations listed below. Concentrated efforts have been applied in this year to the following projects: The analysis of HST WFPC 2 images of Jupiter's aurora, including the Io footprint emissions. We have performed a comparative analysis of the lo footprint locations with two magnetic field models, studied the statistical properties of the apparent dawn auroral storms on Jupiter, and found various other repeated patterns in Jupiter's aurora. Analysis and modeling of airglow and auroral Ly alpha emission line profiles from Jupiter. This has included modeling the aurora] line profiles, including the energy degradation of precipitating charged particles and radiative transfer of the emerging emissions. Jupiter's auroral emission line profile is self-absorbed, since it is produced by an internal source, and the resulting emission with a deep central absorption from the overlying atmosphere permits modeling of the depth of the emissions, plus the motion of the emitting layer with respect to the overlying atmospheric column from the observed Doppler shift of the central absorption. By contrast

Multiple sclerosis and pregnancy: a single-centre prospective comparative study.

PubMed

Cuello, J P; Martínez Ginés, M L; Martin Barriga, M L; de Andrés, C

2017-03-01

Multiple sclerosis (MS) is a autoimmune disorder which preferentially affects young women of childbearing age. During pregnancy, the annualized relapse rate (AAR) is modified, but pregnancy has no harm effect on the long-term course of the disease. We aimed to study the clinical course of our MS patients during pregnancy, and compare their obstetrics outcomes with a control group of non-MS patients. A single centre prospective observational study was conducted. We assessed the reproductive history, MS history, pregnancy course and new-born outcome of a cohort of MS patients who had had a pregnancy between january 2007 and july 2012. We compared the global outcomes with a control cohort of 58 age-matched healthy pregnancies. Complete data from 35 consecutive women were analyzed, 40 deliveries. Control groups: 58 patients, 60 deliveries. EDSS at pregnancy 0,7. ARR before pregnancy 0,5. During pregnancy 0,3, after pregnancy 0,4. Twelve patients were on disease-modifying drugs (DMD) before pregnancy, 4 prenatal exposure occurs. The comparison between relapse rate and EDSS before, during and after delivery showed no statistically significant difference. In addition, compared to control group, there were also no differences in the obstetric outcomes. In MS cohort, we found a higher incidence of assisted reproductive treatments and lower breastfeeding rate, both statistically significant. Our series confirms that pregnancy has no negative long term impact on the progression of MS and also suggest that there is no additional morbidity in the pregnancy, comparing to the rest of the population. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Statins and secondary prevention of venous thromboembolism: pooled analysis of published observational cohort studies.

PubMed

Kunutsor, Setor K; Seidu, Samuel; Khunti, Kamlesh

2017-05-21

There have been suggestions that statins may have a potential role in secondary prevention of venous thromboembolism (VTE) [which includes deep vein thrombosis (DVT) and pulmonary embolism (PE)], but the evidence is inconsistent. We aimed to evaluate the association between statin use and risk of recurrent VTE. We conducted a systematic review and meta-analysis of observational cohort studies. All relevant studies which reported associations between statin use and recurrent VTE outcomes were identified from MEDLINE, EMBASE, Web of Science, and manual search of bibliographies from inception to January 2017. Study specific relative risks (RRs) with 95% confidence intervals were aggregated using random effects models. Eight eligible studies comprising of 103 576 participants and 13 168 recurrent VTE outcomes were included in the pooled analysis. In pooled analysis of 7 studies, the RR for recurrent VTE was 0.73 (0.68-0.79) when comparing statin use with no use. There was no evidence of heterogeneity between contributing studies (I2=0%, 0-71%; P = 0.93). The RRs for recurrent PE (three studies) and DVT (two studies) comparing statin use with no statin use were 0.75 (95% CI: 0.58-0.96) and 0.66 (95% CI: 0.60-0.71) respectively. Available evidence from observational cohort studies suggests a beneficial effect of statin use on VTE recurrence. Well-designed intervention studies are needed to corroborate these findings. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

The association between market availability and adherence to antihypertensive medications: an observational study.

PubMed

Evans, Charity D; Eurich, Dean T; Lu, Xinya; Remillard, Alfred J; Shevchuk, Yvonne M; Blackburn, David

2013-02-01

High adherence to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) reported in observational studies has frequently been attributed to improved tolerability. However, these agents are also relatively new to the market compared to other antihypertensive medications. We aimed to determine if an association exists between adherence and market availability of a specific antihypertensive agent. This retrospective cohort study used administrative data from Saskatchewan, Canada. Subjects were ≥40 years of age and received a new antihypertensive medication between 1994 and 2002. The primary outcome was the proportion of subjects achieving optimal adherence (≥80%) at 1 year, stratified by antihypertensive medication class and the year of availability. Adherence was measured using the cumulative mean gap ratio. A total of 36,214 subjects met the inclusion criteria. Optimal adherence was observed in 4987 of 8623 (57.8%) subjects receiving ACEIs and 1013 of 1600 (63.3%) subjects receiving ARBs, but adherence appeared inconsistent when examined within each antihypertensive class. A pattern of increasing mean adherence was observed according to availability in the ACEI subgroup (Spearman r = 0.82; P = 0.007) but not the ARB subgroup (Spearman r = 0.41; P = 0.49). However, the association between availability and optimal adherence converged when ARB and ACEI users were combined (Spearman r = 0.85, P < 0.001). Optimal adherence with ACEIs and ARBs compared to other antihypertensive agents may be associated with their relative availability. To what extent optimal adherence is also associated with improved tolerability, as currently believed, remains to be determined.

Slower CCN growth kinetics of anthropogenic aerosol compared to biogenic aerosol observed at a rural site

NASA Astrophysics Data System (ADS)

Shantz, N. C.; Chang, R. Y.-W.; Slowik, J. G.; Vlasenko, A.; Abbatt, J. P. D.; Leaitch, W. R.

2010-01-01

Growth rates of water droplets were measured with a static diffusion cloud condensation chamber in May-June 2007 at a rural field site in Southern Ontario, Canada, 70 km north of Toronto. The observations include periods when the winds were from the south and the site was impacted by anthropogenic air from the U.S. and Southern Ontario as well as during a 5-day period of northerly wind flow when the aerosol was dominated by biogenic sources. The growth of droplets on anthropogenic size-selected particles centred at 0.1 μm diameter and composed of approximately 40% organic and 60% ammonium sulphate (AS) by mass, was delayed by on the order of 1 s compared to a pure AS aerosol. Simulations of the growth rate on monodisperse particles indicate that a lowering of the water mass accommodation coefficient from αc=1 to an average of αc=0.04 is needed (assuming an insoluble organic with hygroscopicity parameter, κorg, of zero). Simulations of the initial growth rate on polydisperse anthropogenic particles agree best with observations for αc=0.07. In contrast, the growth rate of droplets on size-selected aerosol of biogenic character, consisting of >80% organic, was similar to that of pure AS. Simulations of the predominantly biogenic polydisperse aerosol show agreement between the observations and simulations when κorg=0.2 (with upper and lower limits of 0.5 and 0.07, respectively) and αc=1. Inhibition of water uptake by the anthropogenic organic applied to an adiabatic cloud parcel model in the form of a constant low αc increases the number of droplets in a cloud compared to pure AS. If the αc is assumed to increase with increasing liquid water on the droplets, then the number of droplets decreases which could diminish the indirect climate forcing effect. The slightly lower κorg in the biogenic case decreases the number of droplets in a cloud compared to pure AS.

Issues of reporting in observational studies in veterinary medicine.

PubMed

Sargeant, Jan M; O'Connor, Annette M

2014-02-15

Observational studies are common in veterinary medicine; the results may be used to inform decision-making, future research, or as inputs to systematic reviews or risk assessment. To be of use, the results must be published, all of the outcomes that were assessed must be included in the publication, and the research (methods and results) must be reported in sufficient detail that the reader can evaluate the internal and external validity. In human healthcare, concerns about the completeness of reporting - and evidence that poor reporting is associated with study results - have led to the creation of reporting guidelines; these include the STROBE statement for observational studies. There is evidence from a limited body of research that there also are reporting inadequacies in veterinary observational studies. There are differences between human and veterinary observational studies that might be relevant to recommendations for reporting. Such differences include: the use of observational studies in animal populations for simultaneously estimating disease frequency and risk-factor identification; the distinction between the animal owners who consent to participate and the animals that are the study subjects; and the complexity of organizational levels inherent in animal research (in particular, for studies in livestock species). In veterinary medicine, it is common to have clustering within outcomes (due to animal grouping) and clustering of predictor variables. We argue that there is a compelling need for the scientific community involved in veterinary observational studies to use the STROBE statement, use an amended version of STROBE, or to develop and use reporting guidelines that are specific to veterinary medicine to improve reporting of these studies. Copyright © 2013 Elsevier B.V. All rights reserved.

Evaluation of Multiclass Model Observers in PET LROC Studies

NASA Astrophysics Data System (ADS)

Gifford, H. C.; Kinahan, P. E.; Lartizien, C.; King, M. A.

2007-02-01

A localization ROC (LROC) study was conducted to evaluate nonprewhitening matched-filter (NPW) and channelized NPW (CNPW) versions of a multiclass model observer as predictors of human tumor-detection performance with PET images. Target localization is explicitly performed by these model observers. Tumors were placed in the liver, lungs, and background soft tissue of a mathematical phantom, and the data simulation modeled a full-3D acquisition mode. Reconstructions were performed with the FORE+AWOSEM algorithm. The LROC study measured observer performance with 2D images consisting of either coronal, sagittal, or transverse views of the same set of cases. Versions of the CNPW observer based on two previously published difference-of-Gaussian channel models demonstrated good quantitative agreement with human observers. One interpretation of these results treats the CNPW observer as a channelized Hotelling observer with implicit internal noise

Behavioral observation differentiates the effects of an intervention to promote sleep in premature infants: a pilot study.

PubMed

Lacina, Linda; Casper, Tammy; Dixon, Melodie; Harmeyer, Joann; Haberman, Beth; Alberts, Jeffrey R; Simakajornboon, Narong; Visscher, Marty O

2015-02-01

Sleep and ongoing cycling of sleep states are required for neurosensory processing, learning, and brain plasticity. Many aspects of neonatal intensive care environments such as handling for routine and invasive procedures, bright lighting, and noise can create stress, disrupt behavior, and interfere with sleep in prematurely born infants. The study empirically investigated whether a 30-minute observation of infant sleep states and behavior could differentiate an intervention to promote sleep in premature infants with feeding difficulties relative to conventional care (standard positioning, standard crib mattress [SP]). We included an intervention to determine the ability of the method to discriminate treatments and generate a benchmark for future improvements. The intervention, a conformational positioner (CP), is contoured around the infant to provide customized containment and boundaries. To more fully verify the 30-minute observational sleep results, standard polysomnography was conducted simultaneously and sleep outcomes for the 2 modalities were compared. In a randomized crossover clinical trial, 25 infants, 31.5 ± 0.6 weeks' gestational age and 38.4 ± 0.6 weeks at the study, with gastrointestinal conditions or general feeding difficulties used each intervention during an overnight neonatal intensive care unit sleep study. Infant sleep states and behaviors were observed during two 30-minute periods--that is, on the positioner and mattress--using the naturalistic observation of newborn behavior. Two certified developmental care nurses assessed sleep state, self-regulatory, and stress behaviors during 2-minute intervals and summed over 30 minutes. Sleep characteristics from standard polysomnography were measured at the time of behavior observations. Infants on CP spent significantly less time in alert, active awake, or crying states by observation compared with SP. Surgical subjects spent more time awake, active awake, or crying and displayed a higher number

Mars channel observations 1877-90, compared with modern Orbiter data

NASA Astrophysics Data System (ADS)

Gerstbach, G.

2003-10-01

The astronomic sensation of 1877, Schiaparelli's Canali, were a main research topic for 80 years (in a way they are it now again). Up to Mariner 4 (1965) many institutes believed in melted ice and periodic vegetation along the gray or green linear structures. Mars mapping reached a 2nd summit by Antoniadi, whose map 1936 was the basis of the US Mariner program. But ~1915 the shift from linear to area drawing caused some quality losses in planetography. In the fifties the Canali were mostly interpreted as optical illusions or contrast effects. The rivers and tectonics seen by Orbiters encouraged me to special studies: 60% of Schiaparelli channels correlate with: Albedo patterns, terrace-shadow structures, broad valley systems (e.g. Valles Marineris) and rows of craters or clouds. Experienced observers know that linear structures can be "seen" even if their elements are below the resolution. Feedback of this fact to space-born Remote Sensing is recommended - for maximal use of the modern planet Orbiters and special studies of geology, dust storms and clouds.

Assessment of Developing Intensity Duration Frequency Curves using Satellite Observations (Case Study)

NASA Astrophysics Data System (ADS)

Ombadi, Mohammed; Nguyen, Phu; Sorooshian, Soroosh

2017-12-01

Intensity Duration Frequency (IDF) curves are essential for the resilient design of infrastructures. Since their earlier development, IDF relationships have been derived using precipitation records from rainfall gauge stations. However, with the recent advancement in satellite observation of precipitation which provides near global coverage and high spatiotemporal resolution, it is worthy of attention to investigate the validity of utilizing the relatively short record length of satellite rainfall to generate robust IDF relationships. These satellite-based IDF can address the paucity of such information in the developing countries. Few studies have used satellite precipitation data in IDF development but mainly focused on merging satellite and gauge precipitation. In this study, however, IDF have been derived solely from satellite observations using PERSIANN-CDR (Precipitation Estimation from Remotely Sensed Information Using Artificial Neural Networks-Climate Data Record). The unique PERSIANN-CDR attributes of high spatial resolution (0.25°×0.25°), daily temporal resolution and a record dating back to 1983 allow for the investigation at fine resolution. The results are compared over most of the contiguous United States against NOAA Atlas 14. The impact of using different methods of sampling, distribution estimators and regionalization in the resulting relationships is investigated. Main challenges to estimate robust and accurate IDF from satellite observations are also highlighted.

Validity of the modified RULA for computer workers and reliability of one observation compared to six.

PubMed

Levanon, Yafa; Lerman, Yehuda; Gefen, Amit; Ratzon, Navah Z

2014-01-01

Awkward body posture while typing is associated with musculoskeletal disorders (MSDs). Valid rapid assessment of computer workers' body posture is essential for the prevention of MSD among this large population. This study aimed to examine the validity of the modified rapid upper limb assessment (mRULA) which adjusted the rapid upper limb assessment (RULA) for computer workers. Moreover, this study examines whether one observation during a working day is sufficient or more observations are needed. A total of 29 right-handed computer workers were recruited. RULA and mRULA were conducted. The observations were then repeated six times at one-hour intervals. A significant moderate correlation (r = 0.6 and r = 0.7 for mouse and keyboard, respectively) was found between the assessments. No significant differences were found between one observation and six observations per working day. The mRULA was found to be valid for the assessment of computer workers, and one observation was sufficient to assess the work-related risk factor.

Comparative study on the wake deflection behind yawed wind turbine models

NASA Astrophysics Data System (ADS)

Schottler, Jannik; Mühle, Franz; Bartl, Jan; Peinke, Joachim; Adaramola, Muyiwa S.; Sætran, Lars; Hölling, Michael

2017-05-01

In this wind tunnel campaign, detailed wake measurements behind two different model wind turbines in yawed conditions were performed. The wake deflections were quantified by estimating the rotor-averaged available power within the wake. By using two different model wind turbines, the influence of the rotor design and turbine geometry on the wake deflection caused by a yaw misalignment of 30° could be judged. It was found that the wake deflections three rotor diameters downstream were equal while at six rotor diameters downstream insignificant differences were observed. The results compare well with previous experimental and numerical studies.

Comparative effectiveness of echinocandins versus fluconazole therapy for the treatment of adult candidaemia due to Candida parapsilosis: a retrospective observational cohort study of the Mycoses Study Group (MSG-12).

PubMed

Chiotos, Kathleen; Vendetti, Neika; Zaoutis, Theoklis E; Baddley, John; Ostrosky-Zeichner, Luis; Pappas, Peter; Fisher, Brian T

2016-12-01

A polymorphism in the gene encoding β-1,3-glucan synthase, the target of the echinocandin class of antifungals, results in increased in vitro MICs of the echinocandins. This has resulted in controversy surrounding use of the echinocandins for treatment of Candida parapsilosis candidaemia. We aimed to compare 30 day mortality in adults with C. parapsilosis candidaemia treated with echinocandins versus fluconazole. This is a retrospective observational cohort study. We used the Premier Perspective Database to identify adult patients with C. parapsilosis candidaemia treated with only fluconazole or only an echinocandin as definitive therapy. The primary outcome was 30 day mortality. Propensity scores were derived to estimate the probability the patient would have received either an echinocandin or fluconazole. Inverse probability of treatment weighting (IPTW) was used in a weighted logistic regression to calculate odds of 30 day mortality. There were 307 unique patients with C. parapsilosis candidaemia. One hundred and twenty-six (41%) received fluconazole and 181 (59%) received an echinocandin. Age, gender, race, year of admission, need for ICU resources in the week prior to candidaemia onset, and receipt of vasopressors on the day of candidaemia onset were included in the propensity score model used to calculate inverse probability of treatment weights. Weighted logistic regression demonstrated no difference in 30 day mortality between patients receiving an echinocandin as compared with fluconazole (OR 0.82, 95% CI 0.33-2.07). Our result supports the 2016 IDSA invasive candidiasis guidelines, which no longer clearly favour treatment with fluconazole over an echinocandin for C. parapsilosis candidaemia. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Anthropology and the study of menopause: evolutionary, developmental, and comparative perspectives.

PubMed

Sievert, Lynnette Leidy

2014-10-01

This work aims to consider how the discipline of anthropology contributes to the study of menopause through evolutionary, developmental, and comparative perspectives. This study was a review of skeletal and ethnographic evidence for menopause and postreproductive life in humans' distant past, hypotheses for the evolution of menopause and long postreproductive life, variation in age at menopause with focus on childhood environments, and the study of variation in symptom experience across populations. Longevity, rather than capacity for menopause, sets humans apart from other primates. Skeletal evidence demonstrates that some Neanderthals and archaic Homo sapiens lived to the age at menopause and that at least one third of women in traditional foraging populations live beyond menopause. The evolutionary reasons for why women experience a long postreproductive life continue to be debated. A developmental perspective suggests that early childhood may be a critical time for the environment to irreversibly influence the number of oocytes or rate of follicular atresia and, ultimately, age at menopause. A comparative perspective examines symptom experience at midlife through participant observation, qualitative interviews, and quantitative instruments to gain a holistic understanding of the meaning, experience, and sociocultural context of menopause. An evolutionary perspective suggests that menopause is not a recent phenomenon among humans. A developmental perspective focuses on the influence of early childhood on ovarian function. A comparative perspective expands clinical norms and provides knowledge about the range of human variations.

Lower Risk of Death With SGLT2 Inhibitors in Observational Studies: Real or Bias?

PubMed

Suissa, Samy

2018-01-01

Two recent observational studies reported a remarkably lower rate of all-cause death associated with sodium-glucose cotransporter 2 inhibitor (-SGLT2i) use in all patients with type 2 diabetes and not only those at increased cardiovascular risk. The >50% lower mortality rates reported in these studies are much greater than those found in the BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) and CANagliflozin cardioVascular Assessment Study (CANVAS) randomized trials. We show that these observational studies are affected by time-related biases, including immortal time bias and time-lag bias, which tend to exaggerate the benefits observed with a drug. The Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors (CVD-REAL) study, based on 166,033 users of SGLT2i and 1,226,221 users of other glucose-lowering drugs (oGLD) identified from health care databases of six countries, was affected by immortal time bias. Indeed, the immortal time between the first oGLD prescription and the first SGLT2i prescription was omitted from the analysis, which resulted in increasing the rate of death in the oGLD group and thus producing the appearance of a lower risk of death with SGLT2i use. The Swedish study compared 10,879 SGLT2i/dipeptidyl peptidase 4 inhibitor (DPP-4i) users with 10,879 matched insulin users. Such comparisons involving second-line therapies with a third-line therapy can introduce time-lag bias, as the patients may not be at the same stage of diabetes. This bias is compounded by the fact that the users of insulin had already started their insulin before cohort entry, unlike the new users of SGLT2i. Finally, the study also introduces immortal time bias with respect to the effects of SGLT2i relative to DPP-4i. In conclusion, the >50% lower rate of death with SGLT2i in type 2 diabetes reported by two recent observational studies is likely exaggerated by immortal time and time

A comparative study of the microstructures observed in statically cast and continuously cast Bi-In-Sn ternary eutectic alloy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sengupta, S.; Soda, H.; McLean, A.

2000-01-01

A ternary eutectic alloy with a composition of 57.2 pct Bi, 24.8 pct In, and 18 pct Sn was continuously cast into wire of 2 mm diameter with casting speeds of 14 and 79 mm/min using the Ohno Continuous Casting (OCC) process. The microstructures obtained were compared with those of statically cast specimens. Extensive segregation of massive Bi blocks, Bi complex structures, and tin-rich dendrites was found in specimens that were statically cast. Decomposition of {radical}Sn by a eutectoid reaction was confirmed based on microstructural evidence. Ternary eutectic alloy with a cooling rate of approximately 1 C/min formed a doublemore » binary eutectic. The double binary eutectic consisted of regions of BiIn and decomposed {radical}Sn in the form of a dendrite cell structure and regions of Bi and decomposed {radical}Sn in the form of a complex-regular cell. The Bi complex-regular cells, which are a ternary eutectic constituent, existed either along the boundaries of the BiIn-decomposed {radical}Sn dendrite cells or at the front of elongated dendrite cell structures. In the continuously cast wires, primary Sn dendrites coupled with a small Bi phase were uniformly distributed within the Bi-In alloy matrix. Neither massive Bi phase, Bi complex-regular cells, no BiIn eutectic dendrite cells were observed, resulting in a more uniform microstructure in contrast to the heavily segregated structures of the statically cast specimens.« less

ULF foreshock under radial IMF: THEMIS observations and global kinetic simulation Vlasiator results compared

NASA Astrophysics Data System (ADS)

Palmroth, Minna; Rami, Vainio; Archer, Martin; Hietala, Heli; Afanasiev, Alexandr; Kempf, Yann; Hoilijoki, Sanni; von Alfthan, Sebastian

2015-04-01

For decades, a certain type of ultra low frequency waves with a period of about 30 seconds have been observed in the Earth's quasi-parallel foreshock. These waves, with a wavelength of about an Earth radius, are compressive and propagate with an average angle of 20 degrees with respect of the interplanetary magnetic field (IMF). The latter property has caused trouble to scientists as the growth rate for the instability causing the waves is maximized along the magnetic field. So far, these waves have been characterized by single or multi-spacecraft methods and 2-dimensional hybrid-PIC simulations, which have not fully reproduced the wave properties. Vlasiator is a newly developed, global hybrid-Vlasov simulation, which solves the six-dimensional phase space utilising the Vlasov equation for protons, while electrons are a charge-neutralising fluid. The outcome of the simulation is a global reproduction of ion-scale physics in a holistic manner where the generation of physical features can be followed in time and their consequences can be quantitatively characterised. Vlasiator produces the ion distribution functions and the related kinetic physics in unprecedented detail, in the global scale magnetospheric scale with a resolution of a couple of hundred kilometres in the ordinary space and 20 km/s in the velocity space. We run Vlasiator under a radial IMF in five dimensions consisting of the three-dimensional velocity space embedded in the ecliptic plane. We observe the generation of the 30-second ULF waves, and characterize their evolution and physical properties in time. We compare the results both to THEMIS observations and to the quasi-linear theory. We find that Vlasiator reproduces the foreshock ULF waves in all reported observational aspects, i.e., they are of the observed size in wavelength and period, they are compressive and propagate obliquely to the IMF. In particular, we discuss the issues related to the long-standing question of oblique propagation.

A Comparative Study of Visual Representations in Conventional, Digitized and Interactive High School Science Textbooks

ERIC Educational Resources Information Center

Chen, Xiaoning

2017-01-01

With emerging new technologies being applied in teaching and learning, this study compares visual representations in three different high school biology textbook formats and analyses the senses engaged in viewing and understanding the science content represented through these visuals. The findings show that while a similar pattern is observed in…

Comparative study of talc poudrage versus pleural abrasion for the treatment of primary spontaneous pneumothorax†

PubMed Central

Moreno-Merino, Sergio; Congregado, Miguel; Gallardo, Gregorio; Jimenez-Merchan, Rafael; Trivino, Ana; Cozar, Fernando; Lopez-Porras, Marta; Loscertales, Jesus

2012-01-01

Primary spontaneous pneumothorax is a pathology mainly affecting healthy young patients. Clinical guidelines do not specify the type of pleurodesis that should be conducted, due to the lack of comparative studies on the different techniques. The aim of this study was to compare talc poudrage and pleural abrasion in the treatment of spontaneous pneumothorax. A retrospective comparative study was performed, including 787 patients with primary spontaneous pneumothorax. The 787 patients were classified into two groups: Group A (pleural abrasion) n = 399 and Group B (talc pleurodesis) n = 388. The variables studied were recurrence, surgical time, morbidity and in-hospital length of stay. Statistical analysis was done by an unpaired t-test and Fisher's exact test (SSPS 18.0). Statistically significant differences were observed in the variables: surgical time (A: 46 ± 12.3; B: 37 ± 11.8 min; P < 0.001); length of stay (A: 4.7 ± 2.5; B: 4.3 ± 1.8 days; P = 0.01); apical air camera (A: 25; B: 4; P < 0.001); pleural effusion (A: 6; B: 0; P = 0.05). Talc poudrage shows shorter surgical times and length of stay, and lower re-intervention rates. Morbidity is lower in patients with talc poudrage. Statistically significant differences were not observed in recurrence, persistent air leaks, atelectasis and haemothorax. PMID:22514256

Afterglow Population Studies from Swift Follow-Up Observations of Fermi LAT GRBs

NASA Technical Reports Server (NTRS)

Racusin, Judith L.; Oates, S. R.; McEnery, J.; Vasileiou, V.; Troja, E.; Gehrels, N.

2010-01-01

The small population of Fermi LAT detected GRBs discovered over the last year has been providing interesting and unexpected clues into GRB prompt and afterglow emission mechanisms. Over the last 5 years, it has been Swift that has provided the robust data set of UV/optical and X-ray afterglow observations that opened many windows into other components of GRB emission structure. We explore the new ability to utilize both of these observatories to study the same GRBs over 10 orders of magnitude in energy, although not always concurrently. Almost all LAT GRBs that have been followed-up by Swift within 1-day have been clearly detected and carefully observed. We will present the context of the lower-energy afterglows of this special subset of GRBs that has > 100 MeV emission compared to the hundreds in the Swift database that may or may not have been observed by LAT, and theorize upon the relationship between these properties and the origin of the high energy gamma-ray emission.

The LAAS network observation for studying time correlations in extensive air showers

NASA Astrophysics Data System (ADS)

Ochi, Nobuaki; Iyono, A.; Kimura, Hitoomi; Konishi, Takeharu; Nakamura, Toru; Nakatsuka, Takao; Ohara, Soji; Ohmori, Nobuharu; Saito, Katsuhiko; Takahashi, Nobusuke; Tsuji, Shuhei; Wada, Tomonori; Yamamoto, Isao; Yamashita, Yoshihiko; Yanagimoto, Yukio

2003-02-01

The Large Area Air Shower (LAAS) group has been performing a network observation of extensive air showers (EAS) since 1996 in Japan. Ten compact EAS arrays are operating simultaneously at distant stations (up to ≍1000 km) and detecting EAS with mean energy of ≍1015 eV. Each station has 4--12 scintillation counters and a Global Positioning System (GPS), which provides time stamps of EAS triggers with an accuracy of 1μs. As a consequence of the comparable time stamps, uniformly-adjusted detectors and a standardized data format among all stations, we can treat the independent observations as a gigantic EAS detector system as a whole. The primary purpose of the network observation is to study large-scale correlations in ultra-high-energy cosmic rays. On the other hand, three nearby stations within 1~km distance at Okayama area have a possibility to detect extremely-high-energy EAS (≍1019 eV) as coincident triggers of the three stations. The present status of the network and some results from computer simulations are reported here.

Substorm Electric And Magnetic Fields In The Earth's Magnetotail: Observations Compared To The WINDMI Model

NASA Astrophysics Data System (ADS)

Srinivas, P. G.; Spencer, E. A.; Vadepu, S. K.; Horton, W., Jr.

2017-12-01

We compare satellite observations of substorm electric fields and magnetic fields to the output of a low dimensional nonlinear physics model of the nightside magnetosphere called WINDMI. The electric and magnetic field satellite data are used to calculate the E X B drift, which is one of the intermediate variables of the WINDMI model. The model uses solar wind and IMF measurements from the ACE spacecraft as input into a system of 8 nonlinear ordinary differential equations. The state variables of the differential equations represent the energy stored in the geomagnetic tail, central plasma sheet, ring current and field aligned currents. The output from the model is the ground based geomagnetic westward auroral electrojet (AL) index, and the Dst index.Using ACE solar wind data, IMF data and SuperMAG identification of substorm onset times up to December 2015, we constrain the WINDMI model to trigger substorm events, and compare the model intermediate variables to THEMIS and GEOTAIL satellite data in the magnetotail. By forcing the model to be consistent with satellite electric and magnetic field observations, we are able to track the magnetotail energy dynamics, the field aligned current contributions, energy injections into the ring current, and ensure that they are within allowable limts. In addition we are able to constrain the physical parameters of the model, in particular the lobe inductance, the plasma sheet capacitance, and the resistive and conductive parameters in the plasma sheet and ionosphere.

Clinical Research Methodology 2: Observational Clinical Research.

PubMed

Sessler, Daniel I; Imrey, Peter B

2015-10-01

Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. Observational studies are subject to errors attributable to selection bias, confounding, measurement bias, and reverse causation-in addition to errors of chance. Confounding can be statistically controlled to the extent that potential factors are known and accurately measured, but, in practice, bias and unknown confounders usually remain additional potential sources of error, often of unknown magnitude and clinical impact. Causality-the most clinically useful relation between exposure and outcome-can rarely be definitively determined from observational studies because intentional, controlled manipulations of exposures are not involved. In this article, we review several types of observational clinical research: case series, comparative case-control and cohort studies, and hybrid designs in which case-control analyses are performed on selected members of cohorts. We also discuss the analytic issues that arise when groups to be compared in an observational study, such as patients receiving different therapies, are not comparable in other respects.

Comparative study of two commercially pure titanium casting methods

PubMed Central

RODRIGUES, Renata Cristina Silveira; FARIA, Adriana Claudia Lapria; ORSI, Iara Augusta; de MATTOS, Maria da Gloria Chiarello; MACEDO, Ana Paula; RIBEIRO, Ricardo Faria

2010-01-01

The interest in using titanium to fabricate removable partial denture (RPD) frameworks has increased, but there are few studies evaluating the effects of casting methods on clasp behavior. Objective This study compared the occurrence of porosities and the retentive force of commercially pure titanium (CP Ti) and cobalt-chromium (Co-Cr) removable partial denture circumferential clasps cast by induction/centrifugation and plasma/vacuum-pressure. Material and Methods 72 frameworks were cast from CP Ti (n=36) and Co-Cr alloy (n=36; control group). For each material, 18 frameworks were casted by electromagnetic induction and injected by centrifugation, whereas the other 18 were casted by plasma and injected by vacuum-pressure. For each casting method, three subgroups (n=6) were formed: 0.25 mm, 0.50 mm, and 0.75 mm undercuts. The specimens were radiographed and subjected to an insertion/removal test simulating 5 years of framework use. Data were analyzed by ANOVA and Tukey's to compare materials and cast methods (α=0.05). Results Three of 18 specimens of the induction/centrifugation group and 9 of 18 specimens of plasma/vacuum-pressure cast presented porosities, but only 1 and 7 specimens, respectively, were rejected for simulation test. For Co-Cr alloy, no defects were found. Comparing the casting methods, statistically significant differences (p<0.05) were observed only for the Co-Cr alloy with 0.25 mm and 0.50 mm undercuts. Significant differences were found for the 0.25 mm and 0.75 mm undercuts dependent on the material used. For the 0.50 mm undercut, significant differences were found when the materials were induction casted. Conclusion Although both casting methods produced satisfactory CP Ti RPD frameworks, the occurrence of porosities was greater in the plasma/vacuum-pressure than in the induction/centrifugation method, the latter resulting in higher clasp rigidity, generating higher retention force values. PMID:21085805

Dextromethorphan/Quinidine in Migraine Prophylaxis: An Open-label Observational Clinical Study.

PubMed

Berkovich, Regina R; Sokolov, Alexey Y; Togasaki, Daniel M; Yakupova, Aida A; Cesar, Paul-Henry; Sahai-Srivastava, Soma

This study aimed to assess potential efficacy and safety of dextromethorphan/quinidine (DMQ) in prophylactic treatment of migraine in patients with multiple sclerosis (MS) with superimposed pseudobulbar affect (PBA). Multiple sclerosis patients with superimposed PBA and comorbid migraine were enrolled into this open-label observational study at the University of Southern California Comprehensive MS Center. The baseline characteristics included, among other data, frequency and severity of acute migraine attacks and use of migraine relievers. The DMQ was used exclusively per its primary indication - PBA symptoms control - 20/10 mg orally, twice a day for the mean of 4.5 months (the shortest exposure registered was 3 months and the longest, 6 months). To determine whether treatment caused an effect on migraine frequency and severity, the baseline and posttreatment values were compared using nonparametric sign test. Thirty-three MS subjects with PBA, who also suffered from migraines, were identified. Twenty-nine subjects had improvement in headache frequency, 4 had no change, and none had worsening (P < 0.001 as compared with the baseline). Twenty-eight subjects had improvement in headache severity, 5 had no change, and none had worsening (P < 0.001). Our pilot study results provide evidence that DMQ shows promise as a candidate for larger clinical studies evaluating its efficacy for the prevention of migraine headaches.

Stellar granulation as seen in disk-integrated intensity. II. Theoretical scaling relations compared with observations

NASA Astrophysics Data System (ADS)

Samadi, R.; Belkacem, K.; Ludwig, H.-G.; Caffau, E.; Campante, T. L.; Davies, G. R.; Kallinger, T.; Lund, M. N.; Mosser, B.; Baglin, A.; Mathur, S.; Garcia, R. A.

2013-11-01

Context. A large set of stars observed by CoRoT and Kepler shows clear evidence for the presence of a stellar background, which is interpreted to arise from surface convection, i.e., granulation. These observations show that the characteristic time-scale (τeff) and the root-mean-square (rms) brightness fluctuations (σ) associated with the granulation scale as a function of the peak frequency (νmax) of the solar-like oscillations. Aims: We aim at providing a theoretical background to the observed scaling relations based on a model developed in Paper I. Methods: We computed for each 3D model the theoretical power density spectrum (PDS) associated with the granulation as seen in disk-integrated intensity on the basis of the theoretical model published in Paper I. For each PDS we derived the associated characteristic time (τeff) and the rms brightness fluctuations (σ) and compared these theoretical values with the theoretical scaling relations derived from the theoretical model and the measurements made on a large set of Kepler targets. Results: We derive theoretical scaling relations for τeff and σ, which show the same dependence on νmax as the observed scaling relations. In addition, we show that these quantities also scale as a function of the turbulent Mach number (ℳa) estimated at the photosphere. The theoretical scaling relations for τeff and σ match the observations well on a global scale. Quantitatively, the remaining discrepancies with the observations are found to be much smaller than previous theoretical calculations made for red giants. Conclusions: Our modelling provides additional theoretical support for the observed variations of σ and τeff with νmax. It also highlights the important role of ℳa in controlling the properties of the stellar granulation. However, the observations made with Kepler on a wide variety of stars cannot confirm the dependence of our scaling relations on ℳa. Measurements of the granulation background and

Addressing Informatics Barriers to Conducting Observational Comparative Effectiveness Research: A Comparative Case Analysis

ERIC Educational Resources Information Center

Boone, Christopher P. D.

2013-01-01

Background: The U.S. health care system has been under immense scrutiny for ever-increasing costs and poor health outcomes for its patients. Comparative Effectiveness Research (CER) has emerged as a generally accepted practice by providers, policy makers, and scientists as an approach to identify the most clinical- and cost-effective interventions…

From randomized controlled trials to observational studies.

PubMed

Silverman, Stuart L

2009-02-01

Randomized controlled trials are considered the gold standard in the hierarchy of research designs for evaluating the efficacy and safety of a treatment intervention. However, their results can have limited applicability to patients in clinical settings. Observational studies using large health care databases can complement findings from randomized controlled trials by assessing treatment effectiveness in patients encountered in day-to-day clinical practice. Results from these designs can expand upon outcomes of randomized controlled trials because of the use of larger and more diverse patient populations with common comorbidities and longer follow-up periods. Furthermore, well-designed observational studies can identify clinically important differences among therapeutic options and provide data on long-term drug effectiveness and safety.

Comparative histological study of the mammalian facial nucleus.

PubMed

Furutani, Rui; Sugita, Shoei

2008-04-01

We performed comparative Nissl, Klüver-Barrera and Golgi staining studies of the mammalian facial nucleus to classify the morphologically distinct subdivisions and the neuronal types in the rat, rabbit, ferret, Japanese monkey (Macaca fuscata), pig, horse, Risso's dolphin (Grampus griseus), and bottlenose dolphin (Tursiops truncatus). The medial subnucleus was observed in all examined species; however, that of the Risso's and bottlenose dolphins was a poorly-developed structure comprised of scattered neurons. The medial subnuclei of terrestrial mammals were well-developed cytoarchitectonic structures, usually a rounded column comprised of densely clustered neurons. Intermediate and lateral subnuclei were found in all studied mammals, with differences in columnar shape and neuronal types from species to species. The dorsolateral subnucleus was detected in all mammals but the Japanese monkey, whose facial neurons converged into the intermediate subnucleus. The dorsolateral subnuclei of the two dolphin species studied were expanded subdivisions comprised of densely clustered cells. The ventromedial subnuclei of the ferret, pig, and horse were richly-developed columns comprised of large multipolar neurons. Pig and horse facial nuclei contained another ventral cluster, the ventrolateral subnucleus. The facial nuclei of the Japanese monkey and the bottlenose dolphin were similar in their ventral subnuclear organization. Our findings show species-specific subnuclear organization and distribution patterns of distinct types of neurons within morphological discrete subdivisions, reflecting functional differences.

Postoperative outcomes of two- and three-dimensional planning in orthognathic surgery: A comparative study.

PubMed

Wu, Ting-Yu; Lin, Hsiu-Hsia; Lo, Lun-Jou; Ho, Cheng-Ting

2017-08-01

Compared with conventional two-dimensional (2D) planning, three-dimensional (3D) planning in orthognathic surgery yields more accurate anatomical information and enables the precise positioning of maxillary and mandibular segments, particularly for patients with facial asymmetry. Accordingly, surgical outcomes achieved using 3D planning should be superior. This study determined the differences between the 2D and 3D planning techniques by comparing their surgical outcomes. In this retrospective study, patients who underwent surgery following the traditional 2D planning technique were classified into the 2D planning group. Patients in whom the 2D plan was transferred to a 3D system after surgical simulation were classified into the 3D planning group. Surgical outcomes were compared using cephalometric measurements and patient perception of the results. In the 3D planning group, more favorable results were observed in frontal symmetry, change in the angle between the orbital and occlusal lines, frontal ramus inclination, and the distances from the mandibular central incisor and menton to the midsagittal line. No significant differences were observed in the lateral profiles (SNA, SNB, ANB, and angle convexity) of the two groups. Patient satisfaction was favorable in the two groups, but more patients in the 3D planning group reported being very satisfied. The 3D planning technique provided superior overall outcomes. The study findings can be used to augment clinical planning and surgical execution when using a conventional approach. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A Field Guide to Extra-Tropical Cyclones: Comparing Models to Observations

NASA Astrophysics Data System (ADS)

Bauer, M.

2008-12-01

Climate it is said is the accumulation of weather. And weather is not the concern of climate models. Justification for this latter sentiment has long hidden behind coarse model resolutions and blunt validation tools based on climatological maps and the like. The spatial-temporal resolutions of today's models and observations are converging onto meteorological scales however, which means that with the correct tools we can test the largely unproven assumption that climate model weather is correct enough, or at least lacks perverting biases, such that its accumulation does in fact result in a robust climate prediction. Towards this effort we introduce a new tool for extracting detailed cyclone statistics from climate model output. These include the usual cyclone distribution statistics (maps, histograms), but also adaptive cyclone- centric composites. We have also created a complementary dataset, The MAP Climatology of Mid-latitude Storminess (MCMS), which provides a detailed 6 hourly assessment of the areas under the influence of mid- latitude cyclones based on Reanalysis products. Using this we then extract complimentary composites from sources such as ISCCP and GPCP to create a large comparative dataset for climate model validation. A demonstration of the potential usefulness of these tools will be shown. dime.giss.nasa.gov/mcms/mcms.html

Cost-efficient observation of working postures from video recordings--more videos, more observers or more views per observer?

PubMed

Mathiassen, Svend Erik; Liv, Per; Wahlström, Jens

2012-01-01

In ergonomics, assessing the working postures of an individual by observation is a very common practice. The present study investigated whether monetary resources devoted to an observational study should preferably be invested in collecting many video recordings of the work, or in having several observers estimate postures from available videos multiple times. On the basis of a data set of observed working postures among hairdressers, necessary information in terms of posture variability, observer variability, and costs for recording and observing videos was entered into equations providing the total cost of data collection and the precision (informative value) of the resulting estimates of two variables: percentages time with the arm elevated <15 degrees and >90 degrees. In all 160 data collection strategies, differing with respect to the number of video recordings and the number of repeated observations of each recording, were simulated and compared for cost and precision. For both posture variables, the most cost-efficient strategy for a given budget was to engage 4 observers to look at available video recordings, rather than to have one observer look at more recordings. Since the latter strategy is the more common in ergonomics practice, we recommend reconsidering standard practice in observational posture assessment.

Depression and oxidative stress: results from a meta-analysis of observational studies.

PubMed

Palta, Priya; Samuel, Laura J; Miller, Edgar R; Szanton, Sarah L

2014-01-01

To perform a systematic review and meta-analysis that quantitatively tests and summarizes the hypothesis that depression results in elevated oxidative stress and lower antioxidant levels. We performed a meta-analysis of studies that reported an association between depression and oxidative stress and/or antioxidant status markers. PubMed and EMBASE databases were searched for articles published from January 1980 through December 2012. A random-effects model, weighted by inverse variance, was performed to pool standard deviation (Cohen's d) effect size estimates across studies for oxidative stress and antioxidant status measures, separately. Twenty-three studies with 4980 participants were included in the meta-analysis. Depression was most commonly measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. A Cohen's d effect size of 0.55 (95% confidence interval = 0.47-0.63) was found for the association between depression and oxidative stress, indicating a roughly 0.55 of 1-standard-deviation increase in oxidative stress among individuals with depression compared with those without depression. The results of the studies displayed significant heterogeneity (I(2) = 80.0%, p < .001). A statistically significant effect was also observed for the association between depression and antioxidant status markers (Cohen's d = -0.24, 95% confidence interval = -0.33 to -0.15). This meta-analysis observed an association between depression and oxidative stress and antioxidant status across many different studies. Differences in measures of depression and markers of oxidative stress and antioxidant status markers could account for the observed heterogeneity. These findings suggest that well-established associations between depression and poor heath outcomes may be mediated by high oxidative stress.

Comparative study of energetic heliospheric electrons at wind and geotail

NASA Technical Reports Server (NTRS)

Chaizy, P. A.; Lanzerotti, L. J.; Lin, R. P.; Lepping, R. P.; Kokubun, S. K.; Bosqued, J.-M.; Sanderson, T. R.; Yamamoto, T.

1997-01-01

The current fleet of both heliospheric and magnetospheric spacecraft provides a unique opportunity of studying spatio-temporal plasma phenomena. Among the numerous topics that can be addressed by such a fleet, figures the 3D study of energetic (greater than 20 keV) solar electron) solar electron events. WIND and GEOTAIL are particulary interesting for such analysis: more than two years of data; up to 3/4 continuous days spent by GEOTAIL in the solar wind; and comparable experiments. During solar electron events, rapid electron flux changes can be associated with these structures. Sometimes they are seen at both spacecraft with a time difference corresponding to the convection time, but sometimes they are observed at one spacecraft but not at the other. Several preliminary conclusions can be drawn from such events: (1) there is direct evidence that, within distances lower than 1.5 x 10(exp 6) km at 1 A (approximately 7000 km at the sun), there are significant spatial variations of (a) the magnetic field line connections to the source region and probably of (b) the particle propagation features; (2) magnetic field lines inside and outside particle propagation structures can keep distinct access to the source region for more than one hour; (3) flux waves, of probable local origin, were observed; and (4) within one hour, spatial flux discrepancies, separated by magnetic structures, may remain or disappear.

Longitudinal changes in gray matter regions after cranial radiation and comparative analysis with whole body radiation: a DTI study.

PubMed

Watve, Apurva; Gupta, Mamta; Khushu, Subash; Rana, Poonam

2018-06-01

Radiation-induced white matter changes are well known and vastly studied. However, radiation-induced gray matter alterations are still a research question. In the present study, these changes were assessed in a longitudinal manner using Diffusion Tensor Imaging (DTI) and further compared for cranial and whole body radiation exposure. Male mice (C57BL/6) were irradiated with cranial or whole body radiation followed by DTI study at 7T animal MRI system during predose, subacute and early delayed phases of radiation sickness. Fractional anisotropy (FA) and mean diffusivity (MD) values were obtained from brain's gray matter regions. Decreased FA with increased MD was observed prominently in animals exposed to cranial radiation showing most changes at 8 months post irradiation. However, whole body radiation induced FA changes were mostly observed at 1 month post irradiation as compared to controls. The differential response after whole body and cranial irradiation observed in the study depicts that radiation exposure of 5 Gy could induce permanent alterations in gray matter regions prominently as observed in Caudoputamen region at all the time points. Thus, our study has bolstered the role of DTI to probe microstructural changes in gray matter regions of brain after radiation exposure.

Long-Term Testosterone Therapy Improves Cardiometabolic Function and Reduces Risk of Cardiovascular Disease in Men with Hypogonadism: A Real-Life Observational Registry Study Setting Comparing Treated and Untreated (Control) Groups.

PubMed

Traish, Abdulmaged M; Haider, Ahmad; Haider, Karim Sultan; Doros, Gheorghe; Saad, Farid

2017-09-01

In the absence of large, prospective, placebo-controlled studies of longer duration, substantial evidence regarding the safety and risk of testosterone (T) therapy (TTh) with regard to cardiovascular (CV) outcomes can only be gleaned from observational studies. To date, there are limited studies comparing the effects of long-term TTh in men with hypogonadism who were treated or remained untreated with T, for obvious reasons. We have established a registry to assess the long-term effectiveness and safety of T in men in a urological setting. Here, we sought to compare the effects of T on a host of parameters considered to contribute to CV risk in treated and untreated men with hypogonadism (control group). Observational, prospective, cumulative registry study in 656 men (age: 60.7 ± 7.2 years) with total T levels ≤12.1 nmol/L and symptoms of hypogonadism. In the treatment group, men (n = 360) received parenteral T undecanoate (TU) 1000 mg/12 weeks following an initial 6-week interval for up to 10 years. Men (n = 296) who had opted against TTh served as controls. Median follow-up in both groups was 7 years. Measurements were taken at least twice a year, and 8-year data were analyzed. Mean changes over time between the 2 groups were compared by means of a mixed-effects model for repeated measures, with a random effect for intercept and fixed effects for time, group, and their interaction. To account for baseline differences between the 2 groups, changes were adjusted for age, weight, waist circumference, fasting glucose, blood pressure, and lipids. There were 2 deaths in the T-treated group, none was related to CV events. There were 21 deaths in the untreated (control) group, 19 of which were related to CV events. The incidence of death in 10 patient-years was 0.1145 in the control group (95% confidence interval [CI]: 0.0746-0.1756; P < .000) and 0.0092 in the T-treated group (95% CI: 0.0023-0.0368; P < .000); the estimated difference between groups was 0.0804 (95

Study of observed microearthquakes at Masada Deep Borehole

NASA Astrophysics Data System (ADS)

Hofstetter, A.; Malin, P. E.

2017-12-01

Seismological measurements, conducted at great depths of several hundred of meters or even a few km, can provide useful information that one cannot get while conducting the measurements on the surface. We take advantage of Masada Deep borehole (MDBI), an abandoned oil well, for the installation of a seismometer at a large depth of 1,256 m (1,516 bsl). The station is located in the near vicinity of the East Masada fault, part of the Western Boundary Fault of the Dead Sea basin. We present seismic observations of microearthquakes which occurred along the Dead Sea fault (DSF). Many of them were not recorded by the Israel Seismic Network (ISN). The quiet site of the station has an obvious advantage in detection and identification of earthquakes and explosions. For example, the station detects about 30% more quarry explosions as compared to observations of the ISN. We demonstrate that borehole seismograms are clearer than the on-surface observations of nearby seismometer. We lowered the magnitude scale of observed events down to about M≈-3. Many of the earthquakes, sometimes clusters, occurred underneath the MDBI at depths of 10-25 km, having special signature. Using the cross-correlation technique we present several series of seismic activity either underneath the station or along the DSF. Frequency-magnitude relationship, known also as Gutenberg-Richter relationship, is somewhat higher than the determined value for the whole Dead Sea Fault.

Comparative analysis of atmosphere temperature variability for Northern Eurasia based on the Reanalysis and in-situ observed data

NASA Astrophysics Data System (ADS)

Shulgina, T.; Genina, E.; Gordov, E.; Nikitchuk, K.

2009-04-01

At present numerous data archives which include meteorological observations as well as climate processes modeling data are available for Earth Science specialists. Methods of mathematical statistics are widely used for their processing and analysis. In many cases they represent the only way of quantitative assessment of the meteorological and climatic information. Unified set of analysis methods allows us to compare climatic characteristics calculated on the basis of different datasets with the purpose of performing more detailed analysis of climate dynamics for both regional and global levels. The report presents the results of comparative analysis of atmosphere temperature behavior for the Northern Eurasia territory for the period from 1979 to 2004 based on the NCEP/NCAR Reanalysis, NCEP/DOE Reanalysis AMIP II, JMA/CRIEPI JRA-25 Reanalysis, ECMWF ERA-40 Reanalysis data and observation data obtained from meteorological stations of the former Soviet Union. Statistical processing of atmosphere temperature data included analysis of time series homogeneity of climate indices approved by WMO, such as "Number of frost days", "Number of summer days", "Number of icing days", "Number of tropical nights", etc. by means of parametric methods of mathematical statistics (Fisher and Student tests). That allowed conducting comprehensive research of spatio-temporal features of the atmosphere temperature. Analysis of the atmosphere temperature dynamics revealed inhomogeneity of the data obtained for large observation intervals. Particularly, analysis performed for the period 1979 - 2004 showed the significant increase of the number of frost and icing days approximately by 1 day for every 2 years and decrease roughly by 1 day for 2 years for the number of summer days. Also it should be mentioned that the growth period mean temperature have increased by 1.5 - 2° C for the time period being considered. The usage of different Reanalysis datasets in conjunction with in-situ observed

SABRE observations of Pi2 pulsations: case studies

NASA Astrophysics Data System (ADS)

Bradshaw, E. G.; Lester, M.

1997-01-01

The characteristics of substorm-associated Pi2 pulsations observed by the SABRE coherent radar system during three separate case studies are presented. The SABRE field of view is well positioned to observe the differences between the auroral zone pulsation signature and that observed at mid-latitudes. During the first case study the SABRE field of view is initially in the eastward electrojet, equatorward and to the west of the substorm-enhanced electrojet current. As the interval progresses, the western, upward field-aligned current of the substorm current wedge moves westward across the longitudes of the radar field of view. The westward motion of the wedge is apparent in the spatial and temporal signatures of the associated Pi2 pulsation spectra and polarisation sense. During the second case study, the complex field-aligned and ionospheric currents associated with the pulsation generation region move equatorward into the SABRE field of view and then poleward out of it again after the third pulsation in the series. The spectral content of the four pulsations during the interval indicate different auroral zone and mid-latitude signatures. The final case study is from a period of low magnetic activity when SABRE observes a Pi2 pulsation signature from regions equatorward of the enhanced substorm currents. There is an apparent mode change between the signature observed by SABRE in the ionosphere and that on the ground by magnetometers at latitudes slightly equatorward of the radar field of view. The observations are discussed in terms of published theories of the generation mechanisms for this type of pulsation. Different signatures are observed by SABRE depending on the level of magnetic activity and the position of the SABRE field of view relative to the pulsation generation region. A twin source model for Pi2 pulsation generation provides the clearest explanation of the signatures observed Acknowledgements. The authors are grateful to Prof. D. J. Southwood

Multicenter observational prehospital resuscitation on helicopter study.

PubMed

Holcomb, John B; Swartz, Michael D; DeSantis, Stacia M; Greene, Thomas J; Fox, Erin E; Stein, Deborah M; Bulger, Eileen M; Kerby, Jeffrey D; Goodman, Michael; Schreiber, Martin A; Zielinski, Martin D; O'Keeffe, Terence; Inaba, Kenji; Tomasek, Jeffrey S; Podbielski, Jeanette M; Appana, Savitri N; Yi, Misung; Wade, Charles E

2017-07-01

Earlier use of in-hospital plasma, platelets, and red blood cells (RBCs) has improved survival in trauma patients with severe hemorrhage. Retrospective studies have associated improved early survival with prehospital blood product transfusion (PHT). We hypothesized that PHT of plasma and/or RBCs would result in improved survival after injury in patients transported by helicopter. Adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers were prospectively observed from January to November 2015. Five helicopter systems had plasma and/or RBCs, whereas the other four helicopter systems used only crystalloid resuscitation. All patients meeting predetermined high-risk criteria were analyzed. Patients receiving PHT were compared with patients not receiving PHT. Our primary analysis compared mortality at 3 hours, 24 hours, and 30 days, using logistic regression to adjust for confounders and site heterogeneity to model patients who were matched on propensity scores. Twenty-five thousand one hundred eighteen trauma patients were admitted, 2,341 (9%) were transported by helicopter, of which 1,058 (45%) met the highest-risk criteria. Five hundred eighty-five of 1,058 patients were flown on helicopters carrying blood products. In the systems with blood available, prehospital median systolic blood pressure (125 vs 128) and Glasgow Coma Scale (7 vs 14) was significantly lower, whereas median Injury Severity Score was significantly higher (21 vs 14). Unadjusted mortality was significantly higher in the systems with blood products available, at 3 hours (8.4% vs 3.6%), 24 hours (12.6% vs 8.9%), and 30 days (19.3% vs 13.3%). Twenty-four percent of eligible patients received a PHT. A median of 1 unit of RBCs and plasma were transfused prehospital. Of patients receiving PHT, 24% received only plasma, 7% received only RBCs, and 69% received both. In the propensity score matching analysis (n = 109), PHT was not significantly associated with mortality

Empirical Performance of Covariates in Education Observational Studies

ERIC Educational Resources Information Center

Wong, Vivian C.; Valentine, Jeffrey C.; Miller-Bains, Kate

2017-01-01

This article summarizes results from 12 empirical evaluations of observational methods in education contexts. We look at the performance of three common covariate-types in observational studies where the outcome is a standardized reading or math test. They are: pretest measures, local geographic matching, and rich covariate sets with a strong…

Epidemic of Koro in North East India: an observational cross-sectional study.

PubMed

Kumar, Rajesh; Phookun, Hemendra Ram; Datta, Arunava

2014-12-01

Koro is a culture bound syndrome, endemic in South-East Asia. The present study attempts to correlate the socio-cultural and demographic variables of the patients with the occurrence of the Koro and the differences in presentation between the classical features of the Koro and the actual presentation of the disease that has been observed in the present study. A cross-sectional observational study was performed and data collected during the period was compared, analyzed and studied. A total number of 70 patients who presented to the Department of Psychiatry with symptoms of Koro over the period of 5 days were taken into the study. Most of the patients were, young, unmarried males belonging to a lower socioeconomic status. Most of these patients suffered the attacks in the evening mostly while at home. It was common in migrant and migrant lineage. Media had a major role to spread this epidemic. Koro epidemics are considered to be the result of panic that spread following the occurrence of symptoms in one or more individuals within the same geographical zone. While the issues concerning phenomenology, diagnosis and nosology of Koro are still being discussed, it is apparent that Koro which presents as an acute anxiety state is treatment responsive and has good prognosis. Copyright © 2014 Elsevier B.V. All rights reserved.

STRengthening Analytical Thinking for Observational Studies: the STRATOS initiative

PubMed Central

Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

2014-01-01

The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even ‘standard’ analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. PMID:25074480

STRengthening analytical thinking for observational studies: the STRATOS initiative.

PubMed

Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

2014-12-30

The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even 'standard' analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

Yogurt and Diabetes: Overview of Recent Observational Studies.

PubMed

Salas-Salvadó, Jordi; Guasch-Ferré, Marta; Díaz-López, Andrés; Babio, Nancy

2017-07-01

The effects of dairy consumption on the prevention of type 2 diabetes remain controversial and depend on the dairy subtype. Yogurt intake has received special attention because its association with health benefits is more consistent than that of other types of dairy products. In the present article, we review those observational studies that evaluated the association between yogurt consumption and type 2 diabetes. We also discuss the possible mechanisms involved in these associations. We found that 13 prospective studies evaluated the association between yogurt intake and type 2 diabetes, most of which showed an inverse association between the frequency of yogurt consumption and the risk of diabetes. In addition to the scientific evidence accumulated from individual prospective studies, several meta-analyses have shown that yogurt consumption has a potential role in diabetes prevention. The most recent analysis shows a 14% lower risk of type 2 diabetes when yogurt consumption was 80-125 g/d compared with no yogurt consumption. The intake of fermented dairy products, especially yogurt, has been inversely associated with variables of glucose metabolism. Yogurt may have probiotic effects that could modulate glucose metabolism. We conclude that yogurt consumption, in the context of a healthy dietary pattern, may reduce the risk of type 2 diabetes in healthy and older adults at high cardiovascular risk. Large-scale intervention studies and randomized clinical trials are warranted to determine if yogurt consumption has beneficial effects on insulin sensitivity and reduces the risk of type 2 diabetes. © 2017 American Society for Nutrition.

Zonisamide in Brain Tumor-Related Epilepsy: An Observational Pilot Study.

PubMed

Maschio, Marta; Dinapoli, Loredana; Zarabla, Alessia; Maialetti, Andrea; Giannarelli, Diana; Fabi, Alessandra; Vidiri, Antonello; Cantelmi, Tonino

Epilepsy heavily affects the quality of life (QoL) of patients with brain tumor because in addition to taking treatments for the oncological illness, patients are required to live with the long-term taking of antiepileptic drugs (AEDs). The AEDs' adverse effects are common in these patients and can negatively influence their perceptions of their QoL.We conducted an observational pilot study in patients with brain tumor-related epilepsy to verify efficacy, tolerability, and impact on QoL and global neurocognitive performances of zonisamide (ZNS) in add-on. We recruited 13 patients (5 females, 8 males; mean age, 49.6 years) presenting uncontrolled seizures. At first visit and at final follow-up at 6 months, patients underwent neurological examination, evaluation of adverse events, and cognitive and QoL tests. A seizure diary was given. Eight patients underwent chemotherapy, 3 underwent radiotherapy, and 5 had disease progression. Mean dosage of ZNS at final follow-up was 300 mg/d.Of 9 patients who reached the sixth month follow-up, the mean weekly seizure number before ZNS had been 3.2 ± 5.0, and at final follow-up, the mean weekly seizure number was 0.18 ± 0.41 (P = 0.05).Compared with baseline, we observed stability in all cognitive domains, except for verbal fluency that significantly worsened.Results on QoL tests showed that QoL remained unchanged over time, which could indicate that ZNS did not influence the patients' perceived QoL. Zonisamide as add-on in our patients seems to be well tolerated and efficacious in controlling seizures. Despite having limitations represented by the fact that our study is observational, with a small study population and a short follow-up period, our results confirm that when choosing an AED, in addition to efficacy, the drug's effect on patients' QoL also needs to be considered, especially for patients facing many psychosocial challenges, such as those with brain tumor-related epilepsy.

Nutrition education for student community volunteers: a comparative study of two different communication methods.

PubMed

Vijayapushpam, T; Subba Rao, G M; Antony, Grace Maria; Rao, D Raghunatha

2008-06-01

Nutrition education for student volunteers can enhance their skills, and they can act as change agents in the community. There is a dearth of data from India on the effectiveness of different communication tools in providing nutrition education to student volunteers. This study aims to examine the comparative effectiveness of two different methods of communication--lectures in the classroom aided by print material, and a televised version of a local folk-dance form--for providing nutrition education to student community volunteers in a South Indian state. Interventions were conducted during two mega-camps of student volunteers (camps 1 and 2) with 70 and 137 participants, respectively. Their knowledge levels were tested at baseline. Camp 1 received the lecture intervention and camp 2 the televised folk-dance intervention. Knowledge scores were measured before and after the intervention in each camp, and the two camps were compared for significant improvements in knowledge. At baseline, the knowledge levels of students in both camps were comparable. Significant improvement in knowledge was observed in both camps after intervention (p < .05). Although there was no significant difference between the camps in improvement in knowledge, a significant difference was observed when only the positive increments (improvement over baseline) were compared. The televised version of the folk-dance form was better in bringing about positive increment.

An observational study of drug administration errors in a Malaysian hospital (study of drug administration errors).

PubMed

Chua, S S; Tea, M H; Rahman, M H A

2009-04-01

Drug administration errors were the second most frequent type of medication errors, after prescribing errors but the latter were often intercepted hence, administration errors were more probably to reach the patients. Therefore, this study was conducted to determine the frequency and types of drug administration errors in a Malaysian hospital ward. This is a prospective study that involved direct, undisguised observations of drug administrations in a hospital ward. A researcher was stationed in the ward under study for 15 days to observe all drug administrations which were recorded in a data collection form and then compared with the drugs prescribed for the patient. A total of 1118 opportunities for errors were observed and 127 administrations had errors. This gave an error rate of 11.4 % [95% confidence interval (CI) 9.5-13.3]. If incorrect time errors were excluded, the error rate reduced to 8.7% (95% CI 7.1-10.4). The most common types of drug administration errors were incorrect time (25.2%), followed by incorrect technique of administration (16.3%) and unauthorized drug errors (14.1%). In terms of clinical significance, 10.4% of the administration errors were considered as potentially life-threatening. Intravenous routes were more likely to be associated with an administration error than oral routes (21.3% vs. 7.9%, P < 0.001). The study indicates that the frequency of drug administration errors in developing countries such as Malaysia is similar to that in the developed countries. Incorrect time errors were also the most common type of drug administration errors. A non-punitive system of reporting medication errors should be established to encourage more information to be documented so that risk management protocol could be developed and implemented.

Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK

PubMed Central

2012-01-01

Background The aim of this study is to compare the odds of postpartum haemorrhage among women who opt for home birth against the odds of postpartum haemorrhage for those who plan a hospital birth. It is an observational study involving secondary analysis of maternity records, using binary logistic regression modelling. The data relate to pregnancies that received maternity care from one of fifteen hospitals in the former North West Thames Regional Health Authority Area in England, and which resulted in a live or stillbirth in the years 1988–2000 inclusive, excluding ‘high-risk’ pregnancies, unplanned home births, pre-term births, elective Caesareans and medical inductions. Results Even after adjustment for known confounders such as parity, the odds of postpartum haemorrhage (≥1000ml of blood lost) are significantly higher if a hospital birth is intended than if a home birth is intended (odds ratio 2.5, 95% confidence interval 1.7 to 3.8). The ‘home birth’ group included women who were transferred to hospital during labour or shortly after birth. Conclusions Women and their partners should be advised that the risk of PPH is higher among births planned to take place in hospital compared to births planned to take place at home, but that further research is needed to understand (a) whether the same pattern applies to the more life-threatening categories of PPH, and (b) why hospital birth is associated with increased odds of PPH. If it is due to the way in which labour is managed in hospital, changes should be made to practices which compromise the safety of labouring women. PMID:23157856

A Study of Mesoscale Gravity Waves over the North Atlantic with Satellite Observations and a Mesoscale Model

NASA Technical Reports Server (NTRS)

Wu, Dong L.; Zhang, Fuqing

2004-01-01

Satellite microwave data are used to study gravity wave properties and variabilities over the northeastern United States and the North Atlantic in the December-January periods. The gravity waves in this region, found in many winters, can reach the stratopause with growing amplitude. The Advanced Microwave Sounding Unit-A (AMSU-A) observations show that the wave occurrences are correlated well with the intensity and location of the tropospheric baroclinic jet front systems. To further investigate the cause(s) and properties of the North Atlantic gravity waves, we focus on a series of wave events during 19-21 January 2003 and compare AMSU-A observations to simulations from a mesoscale model (MM5). The simulated gravity waves compare qualitatively well with the satellite observations in terms of wave structures, timing, and overall morphology. Excitation mechanisms of these large-amplitude waves in the troposphere are complex and subject to further investigations.

Comparative effectiveness of injectable penicillin versus a combination of penicillin and gentamicin in children with pneumonia characterised by indrawing in Kenya: protocol for an observational study

PubMed Central

Malla, Lucas; Perera-Salazar, Rafael; McFadden, Emily; English, Mike

2017-01-01

Introduction WHO treatment guidelines are widely recommended for guiding treatment for millions of children with pneumonia every year across multiple low-income and middle-income countries. Guidelines are based on synthesis of available evidence that provides moderate certainty in evidence of effects for forms of pneumonia that can result in hospitalisation. However, trials have included fewer children from Africa than other settings, and it is suggested that African children with pneumonia have higher mortality. Thus, despite improving access to recommended treatments and deployment with high coverage of childhood vaccines, pneumonia remains one of the top causes of mortality for children in Kenya. Establishing whether there are benefits of alternative treatment regimens to help reduce mortality would require pragmatic clinical trials. However, these remain relatively expensive and time consuming. This protocol describes an approach to using secondary analysis of a new, large observational dataset as a potentially cheaper and quicker way to examine the comparative effectiveness of penicillin versus penicillin plus gentamicin in treatment of indrawing pneumonia. Addressing this question is important, as although it is now recommended that this form of pneumonia is treated with oral medication as an outpatient, it remains associated with non-trivial mortality that may be higher outside trial populations. Methods and analysis We will use a large observational dataset that captures data on all admissions to 13 Kenyan county hospitals. These data represent the findings of clinicians in practice and, because the system was developed for large observational research, pose challenges of non-random treatment allocation and missing data. To overcome these challenges, this analysis will use a rigorous approach to study design, propensity score methods and multiple imputation to minimise bias. Ethics and dissemination The primary data are held by hospitals participating in

Terminal illness and the increased mortality risk of conventional antipsychotics in observational studies: a systematic review.

PubMed

Luijendijk, Hendrika J; de Bruin, Niels C; Hulshof, Tessa A; Koolman, Xander

2016-02-01

Numerous large observational studies have shown an increased risk of mortality in elderly users of conventional antipsychotics. Health authorities have warned against use of these drugs. However, terminal illness is a potentially strong confounder of the observational findings. So, the objective of this study was to systematically assess whether terminal illness may have biased the observational association between conventional antipsychotics and risk of mortality in elderly patients. Studies were searched in PubMed, CINAHL, Embase, the references of selected studies and articles referring to selected studies (Web of Science). Inclusion criteria were (i) observational studies that estimated (ii) the risk of all-cause mortality in (iii) new elderly users of (iv) conventional antipsychotics compared with atypical antipsychotics or no use. Two investigators assessed the characteristics of the exposure and reference groups, main results, measured confounders and methods used to adjust for unmeasured confounders. We identified 21 studies. All studies were based on administrative medical and pharmaceutical databases. Sicker and older patients received conventional antipsychotics more often than new antipsychotics. The risk of dying was especially high in the first month of use, and when haloperidol was administered per injection or in high doses. Terminal illness was not measured in any study. Instrumental variables that were used were also confounded by terminal illness. We conclude that terminal illness has not been adjusted for in observational studies that reported an increased risk of mortality risk in elderly users of conventional antipsychotics. As the validity of the evidence is questionable, so is the warning based on it. Copyright © 2015 John Wiley & Sons, Ltd.

A roadside study of observable driver distractions.

PubMed

Sullman, Mark J M; Prat, Francesc; Tasci, Duygu Kuzu

2015-01-01

This study investigated the prevalence of observable distractions while driving and the effect of drivers' characteristics and time-related variables on their prevalence. Using roadside observation, 2 independent observers collected data at 4 randomly selected locations in St. Albans, UK. Of the 10,984 drivers observed, 16.8% were engaged in a secondary task, with talking to passengers being the most common distraction (8.8%), followed by smoking (1.9%) and talking on a hands-free mobile phone (1.7%). An additional 1.0% were observed talking on a handheld phone, and the rest of the distractions (e.g., texting, drinking) were recorded in less than 1% of the drivers observed. Gender-related differences were found for a number of different distractions (i.e., talking to passengers, drinking, and handheld mobile phone conversations), but age emerged as a significant predictor for most secondary tasks, including talking to passengers, smoking, hands-free mobile phone use, handheld mobile phone use, texting/keying numbers, drinking, and engagement in any type of distraction (all distractions combined). The overall pattern for age was that middle-aged and older drivers were less likely to be distracted than younger drivers. This work provides further evidence of the relatively high rate of distracted driving in the UK. The findings clearly indicate that younger drivers are more likely to drive distracted, which probably contributes to their higher crash rates.

Comparative Aspects of Management Observed by Heads of Public and Private Schools

ERIC Educational Resources Information Center

Imran, Muhammad

2010-01-01

The major purpose of the research was to compare the management aspects in public and private schools. All the heads of secondary schools of public and private sector of the Punjab province, Pakistan constituted population of the study. A sample of 216 head teachers (fifty percent from public sector schools and fifty percent private schools) was…

Observed and modelled effects of auroral precipitation on the thermal ionospheric plasma: comparing the MICA and Cascades2 sounding rocket events

NASA Astrophysics Data System (ADS)

Lynch, K. A.; Gayetsky, L.; Fernandes, P. A.; Zettergren, M. D.; Lessard, M.; Cohen, I. J.; Hampton, D. L.; Ahrns, J.; Hysell, D. L.; Powell, S.; Miceli, R. J.; Moen, J. I.; Bekkeng, T.

2012-12-01

Auroral precipitation can modify the ionospheric thermal plasma through a variety of processes. We examine and compare the events seen by two recent auroral sounding rockets carrying in situ thermal plasma instrumentation. The Cascades2 sounding rocket (March 2009, Poker Flat Research Range) traversed a pre-midnight poleward boundary intensification (PBI) event distinguished by a stationary Alfvenic curtain of field-aligned precipitation. The MICA sounding rocket (February 2012, Poker Flat Research Range) traveled through irregular precipitation following the passage of a strong westward-travelling surge. Previous modelling of the ionospheric effects of auroral precipitation used a one-dimensional model, TRANSCAR, which had a simplified treatment of electric fields and did not have the benefit of in situ thermal plasma data. This new study uses a new two-dimensional model which self-consistently calculates electric fields to explore both spatial and temporal effects, and compares to thermal plasma observations. A rigorous understanding of the ambient thermal plasma parameters and their effects on the local spacecraft sheath and charging, is required for quantitative interpretation of in situ thermal plasma observations. To complement this TRANSCAR analysis we therefore require a reliable means of interpreting in situ thermal plasma observation. This interpretation depends upon a rigorous plasma sheath model since the ambient ion energy is on the order of the spacecraft's sheath energy. A self-consistent PIC model is used to model the spacecraft sheath, and a test-particle approach then predicts the detector response for a given plasma environment. The model parameters are then modified until agreement is found with the in situ data. We find that for some situations, the thermal plasma parameters are strongly driven by the precipitation at the observation time. For other situations, the previous history of the precipitation at that position can have a stronger

Comparing Visual and Statistical Analysis in Single-Case Studies Using Published Studies

PubMed Central

Harrington, Magadalena; Velicer, Wayne F.

2015-01-01

Little is known about the extent to which interrupted time-series analysis (ITSA) can be applied to short, single-case study designs and whether those applications produce results consistent with visual analysis (VA). This paper examines the extent to which ITSA can be applied to single-case study designs and compares the results based on two methods: ITSA and VA, using papers published in the Journal of Applied Behavior Analysis in 2010. The study was made possible by the development of software called UnGraph® which facilitates the recovery of raw data from the graphs. ITSA was successfully applied to 94% of the examined graphs with the number of observations ranging from 8 to 136. Moderate to high lag 1 autocorrelations (> .50) were found for 46% of the data series. Effect sizes similar to group-level Cohen’s d were identified based on the tertile distribution. Effects ranging from 0.00 to 0.99 were classified as small, those ranging from 1.00 to 2.49 as medium, and large effect sizes were defined as 2.50 or greater. Comparison of the conclusions from VA and ITSA had a low level of agreement (Kappa = .14, accounting for the agreement expected by chance). The results demonstrate that ITSA can be broadly implemented in applied behavior analysis research. These two methods should be viewed as complimentary and used concurrently. PMID:26609876

An Observational Study of Skilled Memory in Waitresses.

ERIC Educational Resources Information Center

Stevens, Joy

A two-phase study about skilled memory as it is used by waitresses included a participant-observer phase and an observational phase. Participants were three experienced waitresses who had worked at a midtown Manhattan restaurant for 14, 7, and 3 years respectively and a team of 5 confederate customers. Waitresses and customers wore microphones.…

The NOAA Satellite Observing System Architecture Study

NASA Technical Reports Server (NTRS)

Volz, Stephen; Maier, Mark; Di Pietro, David

2016-01-01

NOAA is beginning a study, the NOAA Satellite Observing System Architecture (NSOSA) study, to plan for the future operational environmental satellite system that will follow GOES and JPSS, beginning about 2030. This is an opportunity to design a modern architecture with no pre-conceived notions regarding instruments, platforms, orbits, etc. The NSOSA study will develop and evaluate architecture alternatives to include partner and commercial alternatives that are likely to become available. The objectives will include both functional needs and strategic characteristics (e.g., flexibility, responsiveness, sustainability). Part of this study is the Space Platform Requirements Working Group (SPRWG), which is being commissioned by NESDIS. The SPRWG is charged to assess new or existing user needs and to provide relative priorities for observational needs in the context of the future architecture. SPRWG results will serve as input to the process for new foundational (Level 0 and Level 1) requirements for the next generation of NOAA satellites that follow the GOES-R, JPSS, DSCOVR, Jason-3, and COSMIC-2 missions.

A comparative phylogenetic study of genetics and folk music.

PubMed

Pamjav, Horolma; Juhász, Zoltán; Zalán, Andrea; Németh, Endre; Damdin, Bayarlkhagva

2012-04-01

Computer-aided comparison of folk music from different nations is one of the newest research areas. We were intrigued to have identified some important similarities between phylogenetic studies and modern folk music. First of all, both of them use similar concepts and representation tools such as multidimensional scaling for modelling relationship between populations. This gave us the idea to investigate whether these connections are merely accidental or if they mirror population migrations from the past. We raised the question; does the complex structure of musical connections display a clear picture and can this system be interpreted by the genetic analysis? This study is the first to systematically investigate the incidental genetic background of the folk music context between different populations. Paternal (42 populations) and maternal lineages (56 populations) were compared based on Fst genetic distances of the Y chromosomal and mtDNA haplogroup frequencies. To test this hypothesis, the corresponding musical cultures were also compared using an automatic overlap analysis of parallel melody styles for 31 Eurasian nations. We found that close musical relations of populations indicate close genetic distances (<0.05) with a probability of 82%. It was observed that there is a significant correlation between population genetics and folk music; maternal lineages have a more important role in folk music traditions than paternal lineages. Furthermore, the combination of these disciplines establishing a new interdisciplinary research field of "music-genetics" can be an efficient tool to get a more comprehensive picture on the complex behaviour of populations in prehistoric time.

Filicide: a comparative study of maternal versus paternal child homicide.

PubMed

Liem, Marieke; Koenraadt, Frans

2008-01-01

Filicide is the murder of a child by a parent. Historically, filicide was regarded as a female crime, but nowadays, in the West, men have become increasingly likely to be convicted of killing their child. Previous research on filicide has primarily focussed on either maternal or paternal filicide rather than comparing the two. The aim of our study is to examine and compare the socio-demographic, environmental and psychopathological factors underlying maternal and paternal filicide. Data were extracted from records in a forensic psychiatric observation hospital in Utrecht, in the Netherlands for the period 1953-2004. Seventy-nine men and 82 women were detained in the hospital under criminal charges in that period, having killed (132) or attempted to kill (29) their own child(ren). Differences between men and women were found with regard to age, methods of killing and motivation underlying the filicide. Conclusions The categories of filicide identified corresponded to those in studies from other countries, indicating that filicide follows similar patterns throughout the Western world. The fact that 25% of fathers had killed in reaction to threatened separation or divorce, and that over a third of men and more than half of the women were mentally ill at the time may suggest that increased monitoring by primary care physicians under such circumstances might have preventive value. Copyright 2008 John Wiley & Sons, Ltd.

A comparative study of short- and medium-term outcomes comparing emergent surgery and stenting as a bridge to surgery in patients with acute malignant colonic obstruction.

PubMed

Kavanagh, Dara O; Nolan, Blathnaid; Judge, Ciaran; Hyland, John M P; Mulcahy, Hugh E; O'Connell, P Ronan; Winter, Des C; Doherty, Glen A

2013-04-01

The use of self-expanding metal stents as a bridge to surgery in the setting of malignant colorectal obstruction has been advocated as an acceptable alternative to emergency surgery. However, concerns about the safety of stenting have been raised following recent randomized studies. The aim of the current study was to compare outcomes. This was an observational, comparative study. This study was conducted at a tertiary referral center and university teaching hospital. Patients with malignant colonic obstruction (n = 49) treated by either emergency surgery (n = 26) or with stent placement (n = 23) as a bridge to surgery were identified and followed. Short-term outcomes including stoma rates and postoperative morbidity and medium-term oncological outcomes were compared based on an "intention-to-treat" analysis. Patients in both groups were well matched on clinicopathological parameters. Technical and clinical successful stent deployment was achieved in 91% and 83%. This did not adversely impact cancer-specific and overall survival (log rank = nonsignificant). No difference was observed in stoma rates, primary anastomosis rates, perioperative mortality rates, or reoperation rates between the 2 groups. Significantly fewer patients underwent total colectomy in the stent group in comparison with the emergency surgery group (1/23 vs 6/26: p = 0.027). There was no difference in postoperative morbidity (59% vs 66%: p = 0.09). There was a significant reduction in readmission rates in the stent group (5/26 vs 0/23: p = 0.038). The small sample size of this study could lead to type II error. In addition, the study was nonrandomized and demonstrated a limited length of follow-up. Despite a high rate of technical and clinical success in selected patients with colonic obstruction, stenting has no impact on stoma rates. Despite concerns about the rate of stent-associated perforation, stenting does not adversely impact disease progression or survival. Future comparative trials are

Comparative study of microwave radiation-induced magnetoresistive oscillations induced by circularly- and linearly- polarized photo-excitation

PubMed Central

Ye, Tianyu; Liu, Han-Chun; Wang, Zhuo; Wegscheider, W.; Mani, Ramesh G.

2015-01-01

A comparative study of the radiation-induced magnetoresistance oscillations in the high mobility GaAs/AlGaAs heterostructure two dimensional electron system (2DES) under linearly- and circularly- polarized microwave excitation indicates a profound difference in the response observed upon rotating the microwave launcher for the two cases, although circularly polarized microwave radiation induced magnetoresistance oscillations observed at low magnetic fields are similar to the oscillations observed with linearly polarized radiation. For the linearly polarized radiation, the magnetoresistive response is a strong sinusoidal function of the launcher rotation (or linear polarization) angle, θ. For circularly polarized radiation, the oscillatory magnetoresistive response is hardly sensitive to θ. PMID:26450679

Comparative study of microwave radiation-induced magnetoresistive oscillations induced by circularly- and linearly- polarized photo-excitation.

PubMed

Ye, Tianyu; Liu, Han-Chun; Wang, Zhuo; Wegscheider, W; Mani, Ramesh G

2015-10-09

A comparative study of the radiation-induced magnetoresistance oscillations in the high mobility GaAs/AlGaAs heterostructure two dimensional electron system (2DES) under linearly- and circularly- polarized microwave excitation indicates a profound difference in the response observed upon rotating the microwave launcher for the two cases, although circularly polarized microwave radiation induced magnetoresistance oscillations observed at low magnetic fields are similar to the oscillations observed with linearly polarized radiation. For the linearly polarized radiation, the magnetoresistive response is a strong sinusoidal function of the launcher rotation (or linear polarization) angle, θ. For circularly polarized radiation, the oscillatory magnetoresistive response is hardly sensitive to θ.

Clinical photographic observation of plantar corns and callus associated with a nominal scale classification and inter- observer reliability study in a student population.

PubMed

Tollafield, David R

2017-01-01

The management of plantar corns and callus has a low cost-benefit with reduced prioritisation in healthcare. The distinction between types of keratin lesions that forms corns and callus has attracted limited interest. Observation is imperative to improving diagnostic predictions and a number of studies point to some confusion as to how best to achieve this. The use of photographic observation has been proposed to improve our understanding of intractable keratin lesions. Students from a podiatry school reviewed photographs where plantar keratin lesions were divided into four nominal groups; light callus (Grade 1), heavy defined callus (Grade 2), concentric keratin plugs (Grade 3) and callus with deeper density changes under the forefoot (Grade 4). A group of 'experts' assigned from qualified podiatrists validated the observer rated responses by the students. Cohen's weighted statistic (k) was used to measure inter-observer reliability. First year students (unskilled) performed less well when viewing photographs ( k  = 0.33) compared to third year students (semi-skilled, k  = 0.62). The experts performed better than students ( k  = 0.88) providing consistency with wound care models in other studies. Improved clinical annotation of clinical features, supported by classification of keratin- based lesions, combined with patient outcome tools, could improve the scientific rationale to prioritise patient care. Problems associated with photographic assessment involves trying to differentiate similar lesions without the benefit of direct palpation. Direct observation of callus with and without debridement requires further investigation alongside the model proposed in this paper.

Job Burnout among Iranian Elementary School Teachers of Students with Autism: a Comparative Study

PubMed Central

Mohammadi, Mohammad Reza; Ahmadi, Fatemeh; Arsalani, Akram

2013-01-01

Objective Teachers often experience burnout and challenges during their active career. Different studies have shown that those directly involved with teaching children with special needs are more subject to burnout. Due to advance screening tools, more children with autism are now diagnosed and involved in special education. The aim of the present study was to investigate the professional burnout in teachers of children with autism compared to teachers of other children with special needs. Methods Casual Comparative study design was used for this research. Three self-reported measures (Maslach Burnout Inventory, Job Descriptive Index, and General Health Questionnaire) were distributed; clustered sampling selection was conducted to select participants. Ninety three female teachers (32 teachers of children with autism, 30 teachers in schools for deaf and 31 for teachers of children with mental retardation) from 12 schools located in 4 districts of Tehran were selected. Pearson's and Spearman's correlation statistical tests, analysis of variances and regression were used to analyze the results. Results Results of the current study revealed a significant difference in criterion validity between the three groups of teachers The three groups were different in terms of general health (p=0.010), emotional exhaustion (p=0.005) and depersonalization (p<0.001); however considering other variables no significant differences were observed. Comparison between groups showed that the average scores of teachers of children with autism were significantly higher than teachers of deaf and hard of hearing and mentally retarded children in general health, fatigue, and depersonalization variables. No significant differences were observed in average scores of teachers for mentally retarded and deaf children. Conclusions Female teachers’ of children with autism are experiencing significantly higher levels of burnout and general mental health problems compared to teachers of children with

The use of iohexol in pediatric urography: a comparative study with meglumine diatrizoate.

PubMed

Bani, E; Federighi, F; Ghio, R; Marchitiello, M; Galigani, P; Palla, R

1985-01-01

In a prospective study the nephrotoxicity of iohexol, a new non-ionic contrast medium, was compared with meglumine diatrizoate. Plasma creatinine, BUN, creatinine clearance, urinalysis and the urinary excretion of N-acetyl glucosaminidase (NAG), gamma glutamyl transpeptidase (GGT) and muramidase (MU) were determined prior to and following intravenous pyelography. A significant rise in the enzyme excretion was observed in patients who received iohexol and diatrizoate. Statistical analysis failed to demonstrate any difference in nephrotoxicity between the two iodinated contrast media.

Community Engagement in Observational Human Exposure Studies

EPA Science Inventory

Although observational human exposure studies do not deliberately expose participants to chemicals or environmental conditions, merely involving people as research participants and conducting research inside homes raises ethical issues. Community engagement offers a promising st...

Parameter estimation method that directly compares gravitational wave observations to numerical relativity

NASA Astrophysics Data System (ADS)

Lange, J.; O'Shaughnessy, R.; Boyle, M.; Calderón Bustillo, J.; Campanelli, M.; Chu, T.; Clark, J. A.; Demos, N.; Fong, H.; Healy, J.; Hemberger, D. A.; Hinder, I.; Jani, K.; Khamesra, B.; Kidder, L. E.; Kumar, P.; Laguna, P.; Lousto, C. O.; Lovelace, G.; Ossokine, S.; Pfeiffer, H.; Scheel, M. A.; Shoemaker, D. M.; Szilagyi, B.; Teukolsky, S.; Zlochower, Y.

2017-11-01

We present and assess a Bayesian method to interpret gravitational wave signals from binary black holes. Our method directly compares gravitational wave data to numerical relativity (NR) simulations. In this study, we present a detailed investigation of the systematic and statistical parameter estimation errors of this method. This procedure bypasses approximations used in semianalytical models for compact binary coalescence. In this work, we use the full posterior parameter distribution for only generic nonprecessing binaries, drawing inferences away from the set of NR simulations used, via interpolation of a single scalar quantity (the marginalized log likelihood, ln L ) evaluated by comparing data to nonprecessing binary black hole simulations. We also compare the data to generic simulations, and discuss the effectiveness of this procedure for generic sources. We specifically assess the impact of higher order modes, repeating our interpretation with both l ≤2 as well as l ≤3 harmonic modes. Using the l ≤3 higher modes, we gain more information from the signal and can better constrain the parameters of the gravitational wave signal. We assess and quantify several sources of systematic error that our procedure could introduce, including simulation resolution and duration; most are negligible. We show through examples that our method can recover the parameters for equal mass, zero spin, GW150914-like, and unequal mass, precessing spin sources. Our study of this new parameter estimation method demonstrates that we can quantify and understand the systematic and statistical error. This method allows us to use higher order modes from numerical relativity simulations to better constrain the black hole binary parameters.

Depression and Oxidative Stress: Results From a Meta-Analysis of Observational Studies

PubMed Central

Palta, Priya; Samuel, Laura J.; Miller, Edgar R.; Szanton, Sarah L.

2014-01-01

Objective To perform a systematic review and meta-analysis that quantitatively tests and summarizes the hypothesis that depression results in elevated oxidative stress and lower antioxidant levels. Methods We performed a meta-analysis of studies that reported an association between depression and oxidative stress and/or antioxidant status markers. PubMed and EMBASE databases were searched for articles published from January 1980 through December 2012. A random-effects model, weighted by inverse variance, was performed to pool standard deviation (Cohen’s d) effect size estimates across studies for oxidative stress and antioxidant status measures, separately. Results Twenty-three studies with 4980 participants were included in the meta-analysis. Depression was most commonly measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. A Cohen’s d effect size of 0.55 (95% confidence interval = 0.47–0.63) was found for the association between depression and oxidative stress, indicating a roughly 0.55 of 1-standard-deviation increase in oxidative stress among individuals with depression compared with those without depression. The results of the studies displayed significant heterogeneity (I2 = 80.0%, p < .001). A statistically significant effect was also observed for the association between depression and antioxidant status markers (Cohen’s d = −0.24, 95% confidence interval = −0.33 to −0.15). Conclusions This meta-analysis observed an association between depression and oxidative stress and antioxidant status across many different studies. Differences in measures of depression and markers of oxidative stress and antioxidant status markers could account for the observed heterogeneity. These findings suggest that well-established associations between depression and poor heath outcomes may be mediated by high oxidative stress. PMID:24336428

A comparative study of conventionally sintered and microwave sintered nickel zinc ferrite

NASA Astrophysics Data System (ADS)

Rani, Rekha; Juneja, J. K.; Raina, K. K.; Kotnala, R. K.; Prakash, Chandra

2014-04-01

For the present work, nickel zinc ferrite having compositional formula Ni0.8Zn0.2Fe2O4 was synthesized by conventional solid state method and sintered in conventional and microwave furnaces. Pellets were sintered with very short soaking time of 10 min at 1150 °C in microwave furnace whereas 4 hrs of soaking time was selected for conventional sintering at 1200 °C. Phase formation was confirmed by X-ray diffraction analysis technique. Scanning electron micrographs were taken for microstructural study. Dielectric properties were studied as a function of temperature. To study magnetic behavior, M-H hysteresis loops were recorded for both samples. It is observed that microwave sintered sample could obtain comparable properties to the conventionally sintered one in lesser soaking time at lower sintering temperature.

Technology-Enhanced Consultation in Counselling: A Comparative Study

ERIC Educational Resources Information Center

Astramovich, Randall L.; Jones, W. Paul; Coker, J. Kelly

2004-01-01

Two quasi-experimental studies comparing technology-enhanced counselling consultation were conducted with a sample of 147 students enrolled in an undergraduate counselling and consultation course for elementary and secondary teachers. Study 1 (N = 76) compared the effectiveness of counselling consultation using telephone, text chat, or text chat…

Comparing synthetic imagery with real imagery for visible signature analysis: human observer results

NASA Astrophysics Data System (ADS)

Culpepper, Joanne B.; Richards, Noel; Madden, Christopher S.; Winter, Neal; Wheaton, Vivienne C.

2017-10-01

Synthetic imagery could potentially enhance visible signature analysis by providing a wider range of target images in differing environmental conditions than would be feasible to collect in field trials. Achieving this requires a method for generating synthetic imagery that is both verified to be realistic and produces the same visible signature analysis results as real images. Is target detectability as measured by image metrics the same for real images and synthetic images of the same scene? Is target detectability as measured by human observer trials the same for real images and synthetic images of the same scene, and how realistic do the synthetic images need to be? In this paper we present the results of a small scale exploratory study on the second question: a photosimulation experiment conducted using digital photographs and synthetic images generated of the same scene. Two sets of synthetic images were created: a high fidelity set created using an image generation tool, E-on Vue, and a low fidelity set created using a gaming engine, Unity 3D. The target detection results obtained using digital photographs were compared with those obtained using the two sets of synthetic images. There was a moderate correlation between the high fidelity synthetic image set and the real images in both the probability of correct detection (Pd: PCC = 0.58, SCC = 0.57) and mean search time (MST: PCC = 0.63, SCC = 0.61). There was no correlation between the low fidelity synthetic image set and the real images for the Pd, but a moderate correlation for MST (PCC = 0.67, SCC = 0.55).

Generalizing Observational Study Results: Applying Propensity Score Methods to Complex Surveys

PubMed Central

DuGoff, Eva H; Schuler, Megan; Stuart, Elizabeth A

2014-01-01

ObjectiveTo provide a tutorial for using propensity score methods with complex survey data. Data SourcesSimulated data and the 2008 Medical Expenditure Panel Survey. Study DesignUsing simulation, we compared the following methods for estimating the treatment effect: a naïve estimate (ignoring both survey weights and propensity scores), survey weighting, propensity score methods (nearest neighbor matching, weighting, and subclassification), and propensity score methods in combination with survey weighting. Methods are compared in terms of bias and 95 percent confidence interval coverage. In Example 2, we used these methods to estimate the effect on health care spending of having a generalist versus a specialist as a usual source of care. Principal FindingsIn general, combining a propensity score method and survey weighting is necessary to achieve unbiased treatment effect estimates that are generalizable to the original survey target population. ConclusionsPropensity score methods are an essential tool for addressing confounding in observational studies. Ignoring survey weights may lead to results that are not generalizable to the survey target population. This paper clarifies the appropriate inferences for different propensity score methods and suggests guidelines for selecting an appropriate propensity score method based on a researcher’s goal. PMID:23855598

Comparing methods for measuring peak look duration: Are individual differences observed on screen-based tasks also found in more ecologically valid contexts?

PubMed Central

Wass, Sam V.

2014-01-01

Convergent research points to the importance of studying the ontogenesis of sustained attention during the early years of life, but little research hitherto has compared and contrasted different techniques available for measuring sustained attention. Here, we compare methods that have been used to assess one parameter of sustained attention, namely infants’ peak look duration to novel stimuli. Our focus was to assess whether individual differences in peak look duration are stable across different measurement techniques. In a single cohort of 42 typically developing 11-month-old infants we assessed peak look duration using six different measurement paradigms (four screen-based, two naturalistic). Zero-order correlations suggested that individual differences in peak look duration were stable across all four screen-based paradigms, but no correlations were found between peak look durations observed on the screen-based and the naturalistic paradigms. A factor analysis conducted on the dependent variable of peak look duration identified two factors. All four screen-based tasks loaded onto the first factor, but the two naturalistic tasks did not relate, and mapped onto a different factor. Our results question how individual differences observed on screen-based tasks manifest in more ecologically valid contexts. PMID:24905901

A multicenter, prospective, single arm, open label, observational study of sTMS for migraine prevention (ESPOUSE Study).

PubMed

Starling, Amaal J; Tepper, Stewart J; Marmura, Michael J; Shamim, Ejaz A; Robbins, Matthew S; Hindiyeh, Nada; Charles, Andrew C; Goadsby, Peter J; Lipton, Richard B; Silberstein, Stephen D; Gelfand, Amy A; Chiacchierini, Richard P; Dodick, David W

2018-05-01

Objective To evaluate the efficacy and tolerability of single pulse transcranial magnetic stimulation (sTMS) for the preventive treatment of migraine. Background sTMS was originally developed for the acute treatment of migraine with aura. Open label experience has suggested a preventive benefit. The objective of this trial was to evaluate the efficacy and tolerability of sTMS for migraine prevention. Methods The eNeura SpringTMS Post-Market Observational U.S. Study of Migraine (ESPOUSE) Study was a multicenter, prospective, open label, observational study. From December 2014 to March 2016, patients with migraine (n = 263) were consented to complete a 1-month baseline headache diary followed by 3 months of treatment. The treatment protocol consisted of preventive (four pulses twice daily) and acute (three pulses repeated up to three times for each attack) treatment. Patients reported daily headache status, medication use, and device use with a monthly headache diary. The primary endpoint, mean reduction of headache days compared to baseline, was measured over the 28-day period during weeks 9 to 12. The primary endpoint was compared to a statistically-derived placebo estimate (performance goal). Secondary endpoints included: 50% responder rate, acute headache medication consumption, HIT-6, and mean reduction in total headache days from baseline of any intensity. Results Of a total of 263 consented subjects, 229 completed a baseline diary, and 220 were found to be eligible based on the number of headache days. The device was assigned to 217 subjects (Safety Data Set) and 132 were included in the intention to treat Full Analysis Set. For the primary endpoint, there was a -2.75 ± 0.40 mean reduction of headache days from baseline (9.06 days) compared to the performance goal (-0.63 days) ( p < 0.0001). The 50% responder rate of 46% (95% CI 37%, 56%) was also significantly higher ( p < 0.0001) than the performance goal (20%). There was a reduction of -2

From Comparative Education to Comparative Pedagogy: A Physical Education Case Study

ERIC Educational Resources Information Center

Georgakis, Steve; Graham, Jessica

2016-01-01

In the last two decades forces of globalization and the rise of and access to information technology have transformed the nature of educational research. Traditional disciplines such as comparative education have not been immune to these transformational impacts. Although one might expect globalization to promote the study of comparative…

Problem behaviors of low-income children with language delays: an observation study.

PubMed

Qi, Cathy Huaqing; Kaiser, Ann P

2004-06-01

Children from low-income families are at increased risk for significant behavioral and language problems. Early identification of these problems is essential for effective intervention. The purpose of the present study was to use multiple behavioral assessments to examine the behavioral profiles of sixty 3- and 4-year-old children from low-income families enrolled in Head Start programs and to compare the behavior characteristics of 32 children with language delays with those of 28 children with typical language development. Teachers completed the Child Behavior Checklist/Caregiver-Teacher Report Form/2-5 (CTRF; T. M. Achenbach, 1997) and the Social Skills Rating System (SSRS; F. M. Gresham and S. N. Elliott, 1990), and children were observed in the classrooms during structured and unstructured activities. Children with language delays exhibited more problem behaviors and poorer social skills on some of the observational measures than did children with typical language development, as predicted, but not on all.

Electrophysiological Correlates of Observational Learning in Children

ERIC Educational Resources Information Center

Rodriguez Buritica, Julia M.; Eppinger, Ben; Schuck, Nicolas W.; Heekeren, Hauke R.; Li, Shu-Chen

2016-01-01

Observational learning is an important mechanism for cognitive and social development. However, the neurophysiological mechanisms underlying observational learning in children are not well understood. In this study, we used a probabilistic reward-based observational learning paradigm to compare behavioral and electrophysiological markers of…

Io's Volcanism: Thermo-Physical Models of Silicate Lava Compared with Observations of Thermal Emission

NASA Technical Reports Server (NTRS)

Davies, Ashely G.

1996-01-01

Analyses of thermal infrared outbursts from the jovian satellite Io indicate that at least some of these volcanic events are due to silicate lava. Analysis of the January 9, 1990 outburst indicates that this was an active eruption consisting of a large lava flow (with mass eruption rate of order 10(exp 5) cubic m/sec) and a sustained area at silicate liquidus temperatures. This is interpreted as a series of fire fountains along a rift zone. A possible alternative scenario is that of an overflowing lava lake with extensive fire fountaining. The January 9, 1990 event is unique as multispectral observations with respect to time were obtained. In this paper, a model is presented for the thermal energy lost by active and cooling silicate lava flows and lakes on Io. The model thermal emission is compared with Earth-based observations and Voyager IRIS data. The model (a) provides an explanation of the thermal anomalies on Io's surface; (b) provides constraints on flow behavior and extent and infers some flow parameters; and (c) determines flow geometry and change in flow size with time, and the temperature of each part of the flow or lava lake surface as a function of its age. Models of heat output from active lava flows or inactive but recently emplaced lava flows or overturning lava lakes alone are unable to reproduce the observations. If the January 9, 1990 event is the emplacement of a lava flow, the equivalent of 27 such events per year would yield a volume of material sufficient, if uniformly distributed, to resurface all of Io at a rate of 1 cm/year.

Complications of local anaesthesia. An observational study.

PubMed

Brand, H S; Bekker, W; Baart, J A

2009-11-01

Local anaesthesia is increasingly used by dental hygienists. As little is known about the incidence of adverse effects during and after the administration of local anaesthetics, we evaluated side-effects associated with local anaesthesia. A prospective observational study was conducted using standard criteria among a group of 103 patients receiving mandibular block anaesthesia. Physical reactions like clenching fists (14.5%), moaning (12.6%) and turning pale (7.8%) were frequently observed. Patients (3.8%) showed a painful reaction because of needle contact with a nerve or the periosteum. Systemic complications were not observed. After the injection, 41.7% said they felt tense during the administration; 4.9% of the patients reported swallowing problems and 3.9% a tachycardia. These results suggest that administration of local anaesthesia has a small risk of adverse events. Complications, if they occur, seem minor and transient in nature.

Comparative studies on crosslinked and uncrosslinked natural rubber biodegradation by Pseudomonas sp.

PubMed

Roy, Ram Vinod; Das, Mithu; Banerjee, Rintu; Bhowmick, Anil K

2006-12-01

A comparative study on biodegradation of di-cumyl peroxide (DCP) crosslinked and uncrosslinked natural rubber by Pseudomonas sp. was carried out. Decrease in organic carbon content along with the changes in tensile strength of the treated rubber, both DCP crosslinked and uncrosslinked natural rubber, indicated rubber hydrocarbon utilization by the Pseudomonas sp. A decrease in 60.88% MPa and 41.66% MPa was observed after five month's old treated uncrosslinked natural rubber and DCP crosslinked rubber, respectively. Biodegradation was more pronounced in natural uncrosslinked rubber, which was further confirmed by the formation of aldehydic compounds with decrease in CH2 stretching frequencies.

Concordance of Results from Randomized and Observational Analyses within the Same Study: A Re-Analysis of the Women's Health Initiative Limited-Access Dataset.

PubMed

Bolland, Mark J; Grey, Andrew; Gamble, Greg D; Reid, Ian R

2015-01-01

Observational studies (OS) and randomized controlled trials (RCTs) often report discordant results. In the Women's Health Initiative Calcium and Vitamin D (WHI CaD) RCT, women were randomly assigned to CaD or placebo, but were permitted to use personal calcium and vitamin D supplements, creating a unique opportunity to compare results from randomized and observational analyses within the same study. WHI CaD was a 7-year RCT of 1g calcium/400IU vitamin D daily in 36,282 post-menopausal women. We assessed the effects of CaD on cardiovascular events, death, cancer and fracture in a randomized design- comparing CaD with placebo in 43% of women not using personal calcium or vitamin D supplements- and in a observational design- comparing women in the placebo group (44%) using personal calcium and vitamin D supplements with non-users. Incidence was assessed using Cox proportional hazards models, and results from the two study designs deemed concordant if the absolute difference in hazard ratios was ≤0.15. We also compared results from WHI CaD to those from the WHI Observational Study(WHI OS), which used similar methodology for analyses and recruited from the same population. In WHI CaD, for myocardial infarction and stroke, results of unadjusted and 6/8 covariate-controlled observational analyses (age-adjusted, multivariate-adjusted, propensity-adjusted, propensity-matched) were not concordant with the randomized design results. For death, hip and total fracture, colorectal and total cancer, unadjusted and covariate-controlled observational results were concordant with randomized results. For breast cancer, unadjusted and age-adjusted observational results were concordant with randomized results, but only 1/3 other covariate-controlled observational results were concordant with randomized results. Multivariate-adjusted results from WHI OS were concordant with randomized WHI CaD results for only 4/8 endpoints. Results of randomized analyses in WHI CaD were concordant

A Comparative Study between Universal Eclectic Septoplasty Technique and Cottle

PubMed Central

Amaral Neto, Odim Ferreira do; Mizoguchi, Flavio Massao; Freitas, Renato da Silva; Maniglia, João Jairney; Maniglia, Fábio Fabrício; Maniglia, Ricardo Fabrício

2017-01-01

Introduction  Since the last century surgical correction of nasal septum deviation has been improved. The Universal Eclectic Technique was recently reported and there are still few studies dedicated to address this surgical approach. Objective  The objective of this study is to compare the results of septal deviation correction achieved using the Universal Eclectic Technique (UET) with those obtained through Cottle's Technique. Methods  This is a prospective study with two consecutive case series totaling 90 patients (40 women and 50 men), aged between 18 and 55 years. We divided patients into two groups according to the surgical approach. Fifty-three patients underwent septoplasty through Universal Eclectic Technique (UET) and thirty-seven patients were submitted to classical Cottle's septoplasty technique. All patients have answered the Nasal Obstruction Symptom Evaluation Scale (NOSE) questionnaire to assess pre and postoperative nasal obstruction. Results  Statistical analysis showed a significantly shorter operating time for the UET group. Nasal edema assessment performed seven days after the surgery showed a prevalence of mild edema in UET group and moderate edema in Cottle's technique group. In regard to complication rates, UET presented a single case of septal hematoma while in Cottle's technique group we observed: 02 cases of severe edemas, 01 case of incapacitating headache, and 01 complaint of nasal pain. Conclusion  The Universal Eclectic Technique (UET) has proven to be a safe and effective surgical technique with faster symptomatic improvement, low complication rates, and reduced surgical time when compared with classical Cottle's technique. PMID:28680499

Comparative study of predicted and experimentally detected interplanetary shocks

NASA Astrophysics Data System (ADS)

Kartalev, M. D.; Grigorov, K. G.; Smith, Z.; Dryer, M.; Fry, C. D.; Sun, Wei; Deehr, C. S.

2002-03-01

We compare the real time space weather prediction shock arrival times at 1 AU made by the USAF/NOAA Shock Time of Arrival (STOA) and Interplanetary Shock Propagation Model (ISPM) models, and the Exploration Physics International/University of Alaska Hakamada-Akasofu-Fry Solar Wind Model (HAF-v2) to a real time analysis analysis of plasma and field ACE data. The comparison is made using an algorithm that was developed on the basis of wavelet data analysis and MHD identification procedure. The shock parameters are estimated for selected "candidate events". An appropriate automatically performing Web-based interface periodically utilizes solar wind observations made by the ACE at L1. Near real time results as well an archive of the registered interesting events are available on a specially developed web site. A number of events are considered. These studies are essential for the validation of real time space weather forecasts made from solar data.

The Golden Retriever Lifetime Study: establishing an observational cohort study with translational relevance for human health

PubMed Central

Guy, Michael K.; Page, Rodney L.; Jensen, Wayne A.; Olson, Patricia N.; Haworth, J. David; Searfoss, Erin E.; Brown, Diane E.

2015-01-01

The Golden Retriever Lifetime Study (GRLS) is the first prospective longitudinal study attempted in veterinary medicine to identify the major dietary, genetic and environmental risk factors for cancer and other important diseases in dogs. The GRLS is an observational study that will follow a cohort of 3000 purebred Golden Retrievers throughout their lives via annual online questionnaires from the dog owner and annual physical examinations and collection of biological samples by the primary care veterinarian. The field of comparative medicine investigating naturally occurring disorders in pets is specifically relevant to the many diseases that have a genetic basis for disease in both animals and humans, including cancer, blindness, metabolic and behavioural disorders and some neurodegenerative disorders. The opportunity for the GRLS to provide high-quality data for translational comparative medical initiatives in several disease categories is great. In particular, the opportunity to develop a lifetime dataset of lifestyle and activity, environmental exposure and diet history combined with simultaneous annual biological sample sets and detailed health outcomes will provide disease incidence data for this cohort of geographically dispersed dogs and associations with a wide variety of potential risk factors. The GRLS will provide a lifetime historical context, repeated biological sample sets and outcomes necessary to interrogate complex associations between genes and environmental influences and cancer. PMID:26056371

How physicians, patients and observers compare on the use of qualitative and quantitative measures of physician-patient communication

PubMed Central

Gordon, Howard.S.; Street, Richard.L.

2016-01-01

The purpose of this study was to compare several different measures of physician-patient communication. We compared data derived from different measures of three communication behaviors: patient participation; physician information-giving; and physician participatory decision making (PDM) style, from 83 outpatient visits to oncology or thoracic surgery clinics for pulmonary nodules or lung cancer. Communication was measured with rating scales completed by patients and physicians after the consultation and by two different groups of external observers who used rating scales or coded the frequency of communication behaviors, respectively, after listening to an audio-recording of the consultation. Measures were compared using Pearson correlations. Correlations of patients’ and physicians’ ratings of patient participation (r=0.04) and physician PDM style (r=0.03) were low and not significant (P>0.0083 Bonferroni-adjusted). Correlations of observers’ ratings with patients’ or physicians’ ratings for patient participation and physician PDM style were moderate or low (r=0.15, 0.27, 0.07, and 0.01, respectively), but were not statistically significant (P>0.0083 Bonferroni-adjusted). Correlations between observers’ ratings and frequency measures were 0.31, 0.52, and 0.63, and were statistically significant with p-values 0.005, <0.0001, and <0.0001; respectively, for PDM style, information-giving, and patient participation. Our findings highlight the potential for using observers’ ratings as an alternate measure of communication to more labor intensive frequency measures. PMID:26755527

Teaching the Comparative Approach to American Studies.

ERIC Educational Resources Information Center

Seaberg, Stanley

The rationale behind this book of five suggested or sample comparative units contains several elements: 1) an interdisciplinary social science approach to studying the American past, present, and future; and 2) a view of our country's history in terms of a world setting and in the light on contemporary concerns. The global comparative method…

Verification of the astrometric performance of the Korean VLBI network, using comparative SFPR studies with the VLBA AT 14/7 mm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rioja, María J.; Dodson, Richard; Jung, TaeHyun

The Korean VLBI Network (KVN) is a new millimeter VLBI dedicated array with the capability to simultaneously observe at multiple frequencies, up to 129 GHz. The innovative multi-channel receivers present significant benefits for astrometric measurements in the frequency domain. The aim of this work is to verify the astrometric performance of the KVN using a comparative study with the VLBA, a well-established instrument. For that purpose, we carried out nearly contemporaneous observations with the KVN and the VLBA, at 14/7 mm, in 2013 April. The KVN observations consisted of simultaneous dual frequency observations, while the VLBA used fast frequency switchingmore » observations. We used the Source Frequency Phase Referencing technique for the observational and analysis strategy. We find that having simultaneous observations results in superior compensation for all atmospheric terms in the observables, in addition to offering other significant benefits for astrometric analysis. We have compared the KVN astrometry measurements to those from the VLBA. We find that the structure blending effects introduce dominant systematic astrometric shifts, and these need to be taken into account. We have tested multiple analytical routes to characterize the impact of the low-resolution effects for extended sources in the astrometric measurements. The results from the analysis of the KVN and full VLBA data sets agree within 2σ of the thermal error estimate. We interpret the discrepancy as arising from the different resolutions. We find that the KVN provides astrometric results with excellent agreement, within 1σ, when compared to a VLBA configuration that has a similar resolution. Therefore, this comparative study verifies the astrometric performance of the KVN using SFPR at 14/7 mm, and validates the KVN as an astrometric instrument.« less

Comparing cosmological hydrodynamic simulations with observations of high- redshift galaxy formation

NASA Astrophysics Data System (ADS)

Finlator, Kristian Markwart

We use cosmological hydrodynamic simulations to study the impact of outflows and radiative feedback on high-redshift galaxies. For outflows, we consider simulations that assume (i) no winds, (ii) a "constant-wind" model in which the mass-loading factor and outflow speed are constant, and (iii) "momentum-driven" winds in which both parameters vary smoothly with mass. In order to treat radiative feedback, we develop a moment-based radiative transfer technique that operates in both post-processing and coupled radiative hydrodynamic modes. We first ask how outflows impact the broadband spectral energy distributions (SEDs) of six observed reionization-epoch galaxies. Simulations reproduce five regardless of the outflow prescription, while the sixth suggests an unusually bursty star formation history. We conclude that (i) simulations broadly account for available constraints on reionization-epoch galaxies, (ii) individual SEDs do not constrain outflows, and (iii) SED comparisons efficiently isolate objects that challenge simulations. We next study how outflows impact the galaxy mass metallicity relation (MZR). Momentum-driven outflows uniquely reproduce observations at z = 2. In this scenario, galaxies obey two equilibria: (i) The rate at which a galaxy processes gas into stars and outflows tracks its inflow rate; and (ii) The gas enrichment rate owing to star formation balances the dilution rate owing to inflows. Combining these conditions indicates that the MZR is dominated by the (instantaneous) variation of outflows with mass, with more-massive galaxies driving less gas into outflows per unit stellar mass formed. Turning to radiative feedback, we use post-processing simulations to study the topology of reionization. Reionization begins in overdensities and then "leaks" directly into voids, with filaments reionizing last owing to their high density and low emissivity. This result conflicts with previous findings that voids ionize last. We argue that it owes to the

Building Alliances with (In)Voluntary Clients: A Study Focused on Therapists' Observable Behaviors.

PubMed

Sotero, Luciana; Cunha, Diana; da Silva, José Tomás; Escudero, Valentín; Relvas, Ana Paula

2017-12-01

This study aimed to compare therapists' observable behaviors to promote alliances with involuntary and voluntary clients during brief family therapy. The therapists' contributions to fostering alliances were rated in sessions 1 and 4 using videotapes of 29 families who were observed in brief therapy. Using the System for Observing Family Therapy Alliances, trained raters searched for specific therapist behaviors that contributed to or detracted from the four alliance dimensions: engagement in the therapeutic process, an emotional connection with the therapist, safety within the therapeutic system, and a shared sense of purpose within the family. The results showed that when working with involuntary clients, therapists presented more behaviors to foster the clients' engagement and to promote a shared sense of purpose within the family. However, in the fourth session, the therapists in both groups contributed to the alliance in similar ways. The results are discussed in terms of (a) the therapists' alliance-building behaviors, (b) the specificities of each client group, and (c) the implications for clinical practice, training, and research. © 2016 Family Process Institute.

In-Hospital Recruitment to Observational Studies of Stroke

ERIC Educational Resources Information Center

Pickering, Ruth M.; Kunkel, Dorit; Fitton, Carolyn; Ashburn, Ann; Jenkinson, Damian

2010-01-01

The objective of this study was to examine recruitment in three observational follow-up studies of patients with stroke, focusing on reasons for nonparticipation and the role of potential factors in explaining recruitment rates. It comprised secondary analysis of the three studies. Recruitment rates varied between the studies. Between 10 and 50%…

Comparing nutritional requirements, provision and intakes among patients prescribed therapeutic diets in hospital: An observational study.

PubMed

Rattray, Megan; Desbrow, Ben; Roberts, Shelley

Nutrition is an important part of recovery for hospitalized patients. The aim of this study was to assess the nutritional adequacy of meals provided to and consumed by patients prescribed a therapeutic diet. Patients (N = 110) prescribed a therapeutic diet (texture-modified, low-fiber, oral fluid, or food allergy or intolerance diets) for medical or nutritional reasons were recruited from six wards of a tertiary hospital. Complete (24-h) dietary provisions and intakes were directly observed and analyzed for energy (kJ) and protein (g) content. A chart audit gathered demographic, clinical, and nutrition-related information to calculate each patient's disease-specific estimated energy and protein requirements. Provisions and intake were considered adequate if they met ≥75% of the patient's estimated requirements. Mean energy and protein provided to patients (5844 ± 2319 kJ, 53 ± 30 g) were significantly lower than their mean estimated requirements (8786 ± 1641 kJ, 86 ± 18 g). Consequently, mean nutrition intake (4088 ± 2423 kJ, 37 ± 28 g) were significantly lower than estimated requirements. Only 37% (41) of patients were provided with and 18% (20) consumed adequate nutrition to meet their estimated requirements. No therapeutic diet provided adequate food to meet the energy and protein requirements of all recipients. Patients on oral fluid diets had the highest estimated requirements (9497 ± 1455 kJ, 93 ± 16 g) and the lowest nutrient provision (3497 ± 1388 kJ, 25 ± 19 g) and intake (2156 ± 1394 kJ, 14 ± 14 g). Hospitalized patients prescribed therapeutic diets (particularly fluid-only diets) are at risk for malnutrition. Further research is required to determine the most effective strategies to improve nutritional provision and intake among patients prescribed therapeutic diets. Copyright © 2017 Elsevier Inc. All rights reserved.

Company observational post-marketing studies: drug risk assessment and drug research in special populations--a study-based analysis.

PubMed

Hasford, J; Lamprecht, T

1998-01-01

Company observational post-marketing studies (COPS) claim to provide essential data about drug risks and effectiveness in special populations not admitted to pre-approval clinical trials. Since COPS are often mainly regarded as a marketing activity, this study-based analysis tries to evaluate the scientific contributions of COPS. Thirty-five COPS were identified by hand-searching through medical journals, writing to pharmaceutical manufacturers and using MEDLINE. Fourteen COPS evaluated cardiovascular drugs, 9 evaluated NSAIDs and 12 evaluated various other indications. Thirty-five COPS listed effectiveness, 31 listed safety and 8 listed patient compliance as principal objectives. Not a single COPS included a control group. Seventeen of 21 evaluable COPS mentioned extensive exclusion criteria similar to those in clinical trials. Median observation time was 8 weeks, too short for chronic diseases and for adverse drug reactions with longer latency periods. One new adverse event was regarded. Global assessments of the outcomes by physicians dominated and were not based on objective clinical findings. None of the studies specified any details concerning the standardisation of observations or quality-control procedures. The current COPS scheme does not contribute significantly to our knowledge of drug safety and the effects in special populations. Despite serious criticism over the past 20 years, the poor quality of COPS compared with dramatic improvements of pre-approval trials - implies a need for detailed guidelines for non-experimental phase IV research, similar to the Good Clinical Practice-Guideline of the European Community.

Resuscitative Hyperkalemia in Noncrush Trauma: A Prospective, Observational Study

DTIC Science & Technology

2006-12-01

Resuscitative Hyperkalemia in Noncrush Trauma: A Prospective, Observational Study Robert M. Perkins,*† Matthew C. Aboudara,* Kevin C. Abbott,*† and...Surgical Research, San Antonio, Texas The trauma patient is exposed to physiologic processes and life-saving interventions that predispose to hyperkalemia ...in the care of the massively traumatized patient may or may not increase the risk for hyperkalemia . This prospective, observational study was

Traction force during vacuum extraction: a prospective observational study.

PubMed

Pettersson, K; Ajne, J; Yousaf, K; Sturm, D; Westgren, M; Ajne, G

2015-12-01

To investigate the traction force employed during vacuum extractions. Observational cross-sectional study. Obstetric Department, Karolinska University Hospital, Sweden, and the Swedish National Congress of Obstetrics and Gynaecology, 2013. Two hundred women with vacuum extraction at term and 130 obstetricians participating in a simulated setting. In a normal clinical setting, we used a specially adapted device to measure and record the force used to undertake vacuum extraction. In a subsequent part of the study, the force employed for vacuum extraction by a group of obstetricians in a fictive setting was estimated and objectively measured. Applied force during vacuum extraction in relation to the estimated level of difficulty in the delivery; perinatal diagnoses of asphyxia or head trauma; estimated force compared with objectively measured force employed in the fictive setting. The median (minimum-maximum) peak forces for minimum, average and excessive vacuum extraction in the clinical setting were 176 N (5-360 N), 225 N (115-436 N), and 241 N (164-452 N), respectively. In 34% of cases a force in excess of 216 N was employed. There was no correlation between the umbilical arterial pH at delivery and the traction force employed during extraction. Four cases of mild hypoxic ischaemic encephalopathy were observed, three of which were associated with a delivery whereby excessive traction force was employed during the vacuum extraction. In the fictive setting, the actual exerted force was twice the quantitative estimation. The measured forces in the clinical setting were four times higher than that estimated in the fictive setting. Higher than expected levels of traction force were used for vacuum extraction delivery. As obstetricians tend to underestimate the force applied during vacuum extraction, objective measurement with instantaneous feedback may be valuable in raising awareness. © 2015 Royal College of Obstetricians and Gynaecologists.

Media Coverage, Journal Press Releases and Editorials Associated with Randomized and Observational Studies in High-Impact Medical Journals: A Cohort Study.

PubMed

Wang, Michael T M; Bolland, Mark J; Gamble, Greg; Grey, Andrew

2015-01-01

Publication of clinical research findings in prominent journals influences health beliefs and medical practice, in part by engendering news coverage. Randomized controlled trials (RCTs) should be most influential in guiding clinical practice. We determined whether study design of clinical research published in high-impact journals influences media coverage. We compared the incidence and amount of media coverage of RCTs with that of observational studies published in the top 7 medical journals between 1 January 2013 and 31 March 2013. We specifically assessed media coverage of the most rigorous RCTs, those with >1000 participants that reported 'hard' outcomes. There was no difference between RCTs and observational studies in coverage by major newspapers or news agencies, or in total number of news stories generated (all P>0.63). Large RCTs reporting 'hard' outcomes did not generate more news coverage than small RCTs that reported surrogate outcomes and observational studies (all P>0.32). RCTs were more likely than observational studies to attract a journal editorial (70% vs 46%, P = 0.003), but less likely to be the subject of a journal press release (17% vs 50%, P<0.001). Large RCTs that reported 'hard' outcomes did not attract an editorial more frequently than other studies (61% vs 58%, P>0.99), nor were they more likely to be the subject of a journal press release (14% vs 38%, P = 0.14). The design of clinical studies whose results are published in high-impact medical journals is not associated with the likelihood or amount of ensuing news coverage.

Tire pressure special study : vehicle observation data

DOT National Transportation Integrated Search

2001-08-01

Twenty seven percent of passenger cars with : regular passenger car tires have at least one : tire that is underinflated by 8 psi or more. : Tire Pressure Special Study: Vehicle : Observation Data is the third in a series of : research notes co...

A cross-sectional observational study of helmet use among motorcyclists in Wa, Ghana.

PubMed

Akaateba, Millicent Awialie; Amoh-Gyimah, Richard; Yakubu, Ibrahim

2014-03-01

Motorcyclists' injuries and fatalities are a major public health concern in many developing countries including Ghana. This study therefore aimed to investigate the prevalence of helmet use among motorcyclists in Wa, Ghana. The method used involved a cross-sectional roadside observation at 12 randomly selected sites within and outside the CBD of Wa. A total of 14,467 motorcyclists made up of 11,360 riders and 3107 pillion riders were observed during the study period. Most observed riders (86.5%) and pillion riders (61.7%) were males. The overall prevalence of helmet use among the observed motorcyclists was 36.9% (95% CI: 36.1-37.7). Helmet use for riders was 45.8% (95% CI: 44.8-46.7) whilst that for pillion riders was 3.7% (95 CI: 3.0-4.4). Based on logistic regression analysis, higher helmet wearing rates were found to be significantly associated with female gender, weekdays, morning periods and at locations within the CBD. Riders at locations outside the CBD were about 7 times less likely to wear a helmet than riders within the CBD (48.9% compared to 42.3%; χ(2)(1)=49.526; p<0.001). The study concluded that despite the existence of a national helmet legislation that mandates the use of helmets by both riders and pillion riders on all roads in Ghana, helmet use is generally low in Wa. This suggests that all stakeholders in road safety should jointly intensify education on helmet use and pursue rigorous enforcement on all road types especially at locations outside the CBD to improve helmet use in Wa. Copyright © 2013 Elsevier Ltd. All rights reserved.

Caregiver talk to young Spanish-English bilinguals: Comparing direct observation and parent-report measures of dual-language exposure

PubMed Central

Marchman, Virginia A.; Martínez, Lucía Z.; Hurtado, Nereyda; Grüter, Theres; Fernald, Anne

2016-01-01

In research on language development by bilingual children, the early language environment is commonly characterized in terms of the relative amount of exposure a child gets to each language based on parent report. Little is known about how absolute measures of child-directed speech in two languages relate to language growth. In this study of 3-year-old Spanish-English bilinguals (n = 18), traditional parent-report estimates of exposure were compared to measures of the number of Spanish and English words children heard during naturalistic audio recordings. While the two estimates were moderately correlated, observed numbers of child-directed words were more consistently predictive of children's processing speed and standardized test performance, even when controlling for reported proportion of exposure. These findings highlight the importance of caregiver engagement in bilingual children's language outcomes in both of the languages they are learning. PMID:27197746

Assessing validity of observational intervention studies - the Benchmarking Controlled Trials.

PubMed

Malmivaara, Antti

2016-09-01

Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. To create and pilot test a checklist for appraising methodological validity of a BCT. The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies. Key messages Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies.

Operations dashboard: comparative study

NASA Astrophysics Data System (ADS)

Ramly, Noor Nashriq; Ismail, Ahmad Zuhairi; Aziz, Mohd Haris; Ahmad, Nurul Haszeli

2011-10-01

In this present days and age, there are increasing needs for companies to monitor application and infrastructure health. Apart from having proactive measures to secure their application and infrastructure, many see monitoring dashboards as crucial investment in disaster preparedness. As companies struggle to find the best solution to cater for their needs and interest for monitoring their application and infrastructure's health, this paper summarizes the studies made on several known off-the-shelf operations dashboard and in-house developed dashboard. A few criteria of good dashboard are collected from previous studies carried out by several researchers and rank them according to importance and business needs. The finalized criteria that will be discussed in later sections are data visualization, performance indicator, dashboard personalization, audit capability and alert/ notification. Comparative studies between several popular dashboards were then carried out to determine whether they met these criteria that we derived from the first exercise. The findings hopefully can be used to educate and provide an overview of selecting the best IT application and infrastructure operations dashboard that suit business needs, thus become the main contribution of this paper.

Comparative study of microwave radiation-induced magnetoresistive oscillations induced by circularly- and linearly- polarized photo-excitation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ye, Tianyu; Liu, Han -Chun; Wang, Zhuo

A comparative study of the radiation-induced magnetoresistance oscillations in the high mobility GaAs/AlGaAs heterostructure two dimensional electron system (2DES) under linearly- and circularly- polarized microwave excitation indicates a profound difference in the response observed upon rotating the microwave launcher for the two cases, although circularly polarized microwave radiation induced magnetoresistance oscillations observed at low magnetic fields are similar to the oscillations observed with linearly polarized radiation. For the linearly polarized radiation, the magnetoresistive response is a strong sinusoidal function of the launcher rotation (or linear polarization) angle, θ. As a result, for circularly polarized radiation, the oscillatory magnetoresistive response ismore » hardly sensitive to θ.« less

Comparative study of microwave radiation-induced magnetoresistive oscillations induced by circularly- and linearly- polarized photo-excitation

DOE PAGES

Ye, Tianyu; Liu, Han -Chun; Wang, Zhuo; ...

2015-10-09

A comparative study of the radiation-induced magnetoresistance oscillations in the high mobility GaAs/AlGaAs heterostructure two dimensional electron system (2DES) under linearly- and circularly- polarized microwave excitation indicates a profound difference in the response observed upon rotating the microwave launcher for the two cases, although circularly polarized microwave radiation induced magnetoresistance oscillations observed at low magnetic fields are similar to the oscillations observed with linearly polarized radiation. For the linearly polarized radiation, the magnetoresistive response is a strong sinusoidal function of the launcher rotation (or linear polarization) angle, θ. As a result, for circularly polarized radiation, the oscillatory magnetoresistive response ismore » hardly sensitive to θ.« less

Vasopressor Use for Severe Hypotension-A Multicentre Prospective Observational Study.

PubMed

Lamontagne, Francois; Cook, Deborah J; Meade, Maureen O; Seely, Andrew; Day, Andrew G; Charbonney, Emmanuel; Serri, Karim; Skrobik, Yoanna; Hebert, Paul; St-Arnaud, Charles; Quiroz-Martinez, Hector; Mayette, Michaël; Heyland, Daren K

2017-01-01

The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines. In a multicenter prospective cohort study of critically ill adults with severe hypotension, we recorded MAP and vasopressor doses hourly. We investigated variability across patients and centres using multivariable regression models and Analysis of variance (ANOVA), respectively. We included data from 56 patients treated in 6 centers. The mean (standard deviation [SD]) age and Acute Physiology and Chronic Health Evaluation (APACHE) II score were 64 (14) and 25 (8). Half (28 of 56) of the patients were at least 65 years old, and half had chronic hypertension. The patient-averaged MAP while receiving vasopressors was 75 mm Hg (6) and the median (1st quartile, 3rd quartile) duration of vasopressor therapy was 43 hours (23, 84). MAP achieved was not associated with history of underlying hypertension (p = 0.46) but did vary by center (p<0.001). In this multicenter, prospective observational study, the patient-level average MAP while receiving vasopressors for severe hypotension was 75 mmHg, approximately 10 mmHg above current recommendations and stated practices. Moreover, our results do not support the notion that clinicians tailor vasopressor therapy to individual patient characteristics such as underlying chronic hypertension but MAP achieved while receiving vasopressors varied by site.

An Observational Case Study of Near-peer Teaching in Medical and Pharmacy Experiential Training.

PubMed

Sharif-Chan, Bayan; Tankala, Dipti; Leong, Christine; Austin, Zubin; Battistella, Marisa

2016-09-25

Objective. To compare peer teaching in a medical and a pharmacy clinical teaching unit and to provide suggestions for future research in pharmacy near-peer teaching. Methods. This exploratory observational study used principles of ethnographic methodology for data collection and analysis. Observations were collected in a large downtown teaching hospital. An average of 4-6 hours per day were spent observing a team of medical trainees from the Faculty (School) of Medicine in the general internal medicine (unit for two weeks, followed by a team of pharmacy trainees in an ambulatory hemodialysis (HD) unit for two weeks. Data was collected through field notes and informal interviews that were audiotaped and subsequently transcribed. Data was interpreted by the observer and reviewed weekly by two impartial pharmacists. Results. Five major themes emerged: (1) influence of peer teaching hierarchy; (2) educational distance between peer learners and teachers; (3) effect of the clinical teaching unit size on peer learning; (4) trainees' perception of their teaching role in the clinical teaching unit; and (5) influence of daily schedule and workload on peer teaching. As opposed to pharmacy, a hierarchy and pyramidal structure of peer teaching was observed in medical experiential training. There appeared to be no effect of educational distance on near peer teaching; however, perception of teaching role and influence of daily schedule affected near-peer teaching. Conclusion. Through initial comparisons of medical and pharmacy clinical teaching units, this study provides a reflection of elements that may be necessary to successfully implement near-peer teaching in pharmacy experiential training. Future studies in this area should assess learning outcomes and participant satisfaction, preceptor workload, and impact on patient care.

An Observational Case Study of Near-peer Teaching in Medical and Pharmacy Experiential Training

PubMed Central

Sharif-Chan, Bayan; Tankala, Dipti; Leong, Christine; Austin, Zubin

2016-01-01

Objective. To compare peer teaching in a medical and a pharmacy clinical teaching unit and to provide suggestions for future research in pharmacy near-peer teaching. Methods. This exploratory observational study used principles of ethnographic methodology for data collection and analysis. Observations were collected in a large downtown teaching hospital. An average of 4-6 hours per day were spent observing a team of medical trainees from the Faculty (School) of Medicine in the general internal medicine (unit for two weeks, followed by a team of pharmacy trainees in an ambulatory hemodialysis (HD) unit for two weeks. Data was collected through field notes and informal interviews that were audiotaped and subsequently transcribed. Data was interpreted by the observer and reviewed weekly by two impartial pharmacists. Results. Five major themes emerged: (1) influence of peer teaching hierarchy; (2) educational distance between peer learners and teachers; (3) effect of the clinical teaching unit size on peer learning; (4) trainees’ perception of their teaching role in the clinical teaching unit; and (5) influence of daily schedule and workload on peer teaching. As opposed to pharmacy, a hierarchy and pyramidal structure of peer teaching was observed in medical experiential training. There appeared to be no effect of educational distance on near peer teaching; however, perception of teaching role and influence of daily schedule affected near-peer teaching. Conclusion. Through initial comparisons of medical and pharmacy clinical teaching units, this study provides a reflection of elements that may be necessary to successfully implement near-peer teaching in pharmacy experiential training. Future studies in this area should assess learning outcomes and participant satisfaction, preceptor workload, and impact on patient care. PMID:27756922